BR112020013014B1 - SURGICAL INSTRUMENT - Google Patents

Abstract

The present invention relates to a surgical instrument. The surgical instrument comprises an end actuator comprising an ultrasonic blade and a clamping arm. The clamping arm is movable relative to the ultrasonic blade to transition the end actuator between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further comprises a transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein exceeding a predetermined upper limit of the parameter causes the control circuit to execute a first electromechanical system, and wherein exceeding a predetermined lower limit of the parameter causes the control circuit to execute a second electromechanical system that is different from the first electromechanical system.

Description

CROSS REFERENCE TO RELATED PATENT APPLICATIONS

[0001] The present application claims priority under 35 U.S.C.§ 119(e) to provisional US patent application No. 62/721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety.

[0002] The present application claims priority under 35 U.S.C.§ 119(e) to U.S. Provisional Patent Application No. 62/721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS, filed August 23, 2018, the description of which is incorporated herein into reference title in its entirety.

[0003] The present application claims priority under 35 U.S.C.§ 119(e) to provisional US patent application No. 62/721,999, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety.

[0004] The present application claims priority under 35 U.S.C.§ 119(e) to provisional US patent application No. 62/721,994, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety.

[0005] The present application claims priority under 35 U.S.C.§ 119(e) to provisional US patent application No. 62/721,996, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNAL, filed on August 23, 2018, the description of which is incorporated herein by reference in its entirety.

[0006] The present application claims priority under 35 U.S.C.§ 119(e) to provisional patent application No. 62/692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE, filed on June 30, 2018, to the application for provisional US patent No. 62/692,748, entitled SMART ENERGY ARCHITECTURE, filed on June 30, 2018 and provisional US patent application No. 62/692,768, entitled SMART ENERGY DEVICES, filed on June 30, 2018, with the description each of which is incorporated herein by reference in its entirety.

[0007] This application also claims the benefit of priority under 35 U.S.C.§ 119 (e) to U.S. Provisional Patent Application No. 62/650,898 filed March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, to US provisional patent application serial no. 62/650,887, titled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, to provisional patent application serial no. 62/650,882, titled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed on March 30, 2018, and provisional patent application serial no. 62/650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed on March 30, 2018, the description of each of which is here incorporated by reference, in its entirety.

[0008] The present application claims priority under 35 U.S.C.§ 119(e) to US Provisional Patent Application Serial No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, to US Provisional Patent Application serial no. 62/611,340, titled CLOUD-BASED MEDICAL ANALYTICS, filed on December 28, 2017, and US provisional patent application serial no. 62/611,339, titled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the description of each of which is incorporated here by reference, in its entirety.

BACKGROUND OF THE INVENTION

[0009] In a surgical environment, smart power devices may be required in a smart power architecture environment.

FIGURES

[0010] Resources from various aspects are presented with particularity in the attached claims. The various aspects, however, as regards both the organization and the methods of operation, together with additional objects and advantages thereof, may be better understood by reference to the description given below, considered in conjunction with the annexed drawings, as below.

[0011] Figure 1 is a block diagram of a computer-implemented interactive surgical system, in accordance with at least one aspect of the present description.

[0012] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present description.

[0013] Figure 3 is a central device or surgical "hub" paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present description.

[0014] Figure 4 is a partial perspective view of a surgical central controller housing, and a combination generator module slidably received in a surgical central controller housing, in accordance with at least one aspect of the present description.

[0015] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present description.

[0016] Figure 6 illustrates different power bus connectors for a plurality of side docking ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[0017] Figure 7 illustrates a vertical modular housing configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[0018] Figure 8 illustrates a surgical data network comprising a modular communications hub configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a utility facility especially equipped for surgical operations, to the cloud, in accordance with at least one aspect of the present description.

[0019] Figure 9 illustrates a computer-implemented interactive surgical system, in accordance with at least one aspect of the present description.

[0020] Figure 10 illustrates a surgical hub comprising a plurality of modules coupled to the modular control tower, in accordance with at least one aspect of the present description.

[0021] Figure 11 illustrates an aspect of a universal serial bus (USB) network hub device, in accordance with at least one aspect of the present description.

[0022] Figure 12 illustrates a logical diagram of a control system for a surgical instrument or tool, in accordance with at least one aspect of the present description.

[0023] Figure 13 illustrates a control circuit configured to control aspects of the surgical instrument or tool, in accordance with at least one aspect of the present description.

[0024] Figure 14 illustrates a combinational logic circuit configured to control aspects of the surgical instrument or tool, in accordance with at least one aspect of the present description.

[0025] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, in accordance with at least one aspect of the present description.

[0026] Figure 16 illustrates a surgical instrument or tool comprising a plurality of motors that can be activated to perform various functions, in accordance with at least one aspect of the present description.

[0027] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described therein, in accordance with at least one aspect of the present description.

[0028] Figure 18 illustrates a block diagram of a surgical instrument programmed to control distal translation of the displacement member, in accordance with an aspect of the present description.

[0029] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present description.

[0030] Figure 20 is a system configured to execute adaptive ultrasonic blade control algorithms on a surgical data network comprising a modular communication hub, in accordance with at least one aspect of the present description.

[0031] Figure 21 represents an example of a generator, according to at least one aspect of the present description.

[0032] Figure 22 is a surgical system comprising a generator and various surgical instruments usable therewith, in accordance with at least one aspect of the present description.

[0033] Figure 23 is a view of an end actuator, in accordance with at least one aspect of the present description.

[0034] Figure 24 is a diagram of the surgical system of Figure 22, in accordance with at least one aspect of the present description.

[0035] Figure 25 is a model illustrating the Motion branch chain, in accordance with at least one aspect of the present description.

[0036] Figure 26 illustrates a structural view of a generator architecture, in accordance with at least one aspect of the present description.

[0037] Figures 27A to 27C illustrate functional views of a generator architecture, in accordance with at least one aspect of the present description.

[0038] Figures 28A to 28B are structural and functional aspects of a generator, according to at least one aspect of the present description.

[0039] Figure 29 is a schematic diagram of one aspect of an ultrasonic drive circuit.

[0040] Figure 30 is a schematic diagram of the transformer coupled to the ultrasonic drive circuit shown in Figure 29, in accordance with at least one aspect of the present description.

[0041] Figure 31 is a schematic diagram of the transformer shown in Figure 30 coupled to a test circuit, in accordance with at least one aspect of the present description.

[0042] Figure 32 is a schematic diagram of a control circuit, in accordance with at least one aspect of the present description.

[0043] Figure 33 shows a simplified block circuit diagram illustrating another electrical circuit contained within a modular ultrasonic surgical instrument, in accordance with at least one aspect of the present description.

[0044] Figure 34 illustrates a generator circuit divided into multiple stages, in accordance with at least one aspect of the present description.

[0045] Figure 35 illustrates a generator circuit divided into multiple stages in which the first stage circuit is common to the second stage circuit, in accordance with at least one aspect of the present description.

[0046] Figure 36 is a schematic diagram of one aspect of a drive circuit configured to drive a high frequency current (RF), in accordance with at least one aspect of the present description.

[0047] Figure 37 is a schematic diagram of the transformer coupled to the RF drive circuit shown in Figure 34, in accordance with at least one aspect of the present description.

[0048] Figure 38 is a schematic diagram of a circuit comprising separate power supplies for high-power drive/power circuits and low-power circuits, in accordance with an aspect of the present description.

[0049] Figure 39 illustrates a control circuit that allows a dual generator system to switch between the power modes of the RF generator and the ultrasonic generator for a surgical instrument.

[0050] Figure 40 illustrates a diagram of an aspect of a surgical instrument comprising a feedback system for use with a surgical instrument, in accordance with an aspect of the present description.

[0051] Figure 41 illustrates one aspect of a fundamental architecture for a direct digital synthesis circuit as a direct digital synthesis (DDS) circuit configured to generate a plurality of waveforms for the electrical signal waveform for use in any of the surgical instruments, in accordance with at least one aspect of the present description.

[0052] Figure 42 illustrates one aspect of the digital direct synthesis (DDS) circuit configured to generate a plurality of waveforms for the electrical signal waveform for use in a surgical instrument, in accordance with at least one aspect of the present description.

[0053] Figure 43 illustrates a cycle of a discrete-time digital electrical signal waveform, in accordance with at least one aspect of the present description, of an analog waveform (shown superimposed on an electrical signal waveform discrete-time digital for comparison purposes), in accordance with at least one aspect of the present description.

[0054] Figure 44 is a diagram of a control system configured to provide progressive closure of a closing member as it advances distally to close the clamping arm to apply a closing force load at a desired rate in accordance with a aspect of the present description.

[0055] Figure 45 illustrates a proportional, integral, derivative (PID) controller feedback control system, in accordance with an aspect of the present description.

[0056] Figure 46 is an exploded elevation view of the modular handheld ultrasonic surgical instrument showing the left half of the housing removed from a handle assembly exposing a device identifier communicatively coupled to the multi-lead terminal handle assembly. , in accordance with an aspect of the present description.

[0057] Figure 47 is a detail view of a trigger and key portion of the ultrasonic surgical instrument shown in Figure 46, in accordance with at least one aspect of the present description.

[0058] Figure 48 is a fragmentary enlarged perspective view of an end actuator from a distal end with a claw member in an open position, in accordance with at least one aspect of the present description.

[0059] Figure 49 is a system diagram of a segmented circuit comprising a plurality of independently operated circuit segments, in accordance with at least one aspect of the present description.

[0060] Figure 50 is a circuit diagram of various components of a surgical instrument with motor control functions, in accordance with at least one aspect of the present description.

[0061] Figure 51 illustrates an aspect of an end actuator comprising RF data sensors located on the gripper member, in accordance with at least one aspect of the present description.

[0062] Figure 52 illustrates an aspect of the flexible circuit shown in Figure 51, in which sensors can be mounted on or integrally formed therewith, in accordance with at least one aspect of the present description.

[0063] Figure 53 is an alternative system for controlling the frequency of an ultrasonic electromechanical system and detecting its impedance, in accordance with at least one aspect of the present description.

[0064] Figure 54 is a spectrum of the same ultrasonic device with several different states and conditions of the end actuator in which the phase and impedance magnitude of an ultrasonic transducer are plotted as a function of frequency, according to at least one aspect of this description.

[0065] Figure 55 is a graphical representation of a plot of a three-dimensional training data set S, where the magnitude and phase of the ultrasonic transducer impedance are plotted as a function of frequency, in accordance with at least one aspect of the present description.

[0066] Figure 56 is a logic flow diagram depicting a control program or logic configuration for determining clamp conditions based on the characteristic complex impedance pattern (control point), in accordance with at least one aspect of the present description.

[0067] Figure 57 is a circle plot of complex impedance plotted as an imaginary component versus real components of a piezoelectric vibrator, in accordance with at least one aspect of the present description.

[0068] Figure 58 is a circle plot of complex admittance plotted as an imaginary component versus real components of a piezoelectric vibrator, in accordance with at least one aspect of the present description.

[0069] Figure 59 is a complex admittance circle plot for a 55.5 kHz ultrasonic piezoelectric transducer.

[0070] Figure 60 is a graphical display of an impedance analyzer showing impedance/admittance circle plots for an ultrasonic device with the clamp open and unloaded, where the red color represents admittance and the blue color represents impedance , in accordance with at least one aspect of the present description.

[0071] Figure 61 is a graphical display of an impedance analyzer showing impedance/admittance circle plots for an ultrasonic device with the clamp clamped in dry suede, where the red color represents admittance and the blue color represents impedance , in accordance with at least one aspect of the present description.

[0072] Figure 62 is a graphical display of an impedance analyzer showing impedance/admittance circle plots for an ultrasonic device with the claw tip clamped in damp chamois, wherein the red color represents admittance and the blue color represents the impedance, in accordance with at least one aspect of the present description.

[0073] Figure 63 is a graphical display of an impedance analyzer showing circle plots of impedance/admittance for an ultrasonic device with the claw completely clamped in wet suede, where the red color represents the admittance and the blue color represents the impedance, in accordance with at least one aspect of the present description.

[0074] Figure 64 is a graphical display of an impedance analyzer showing impedance/admittance plots, where the frequency is swept from 48 kHz to 62 kHz to capture multiple resonances from an ultrasonic device with the jaw open , where the gray overlay serves to help visualize the circles, in accordance with at least one aspect of the present description.

[0075] Figure 65 is a logic flow diagram of a process representing a control program or a logic configuration for determining gripper conditions based on estimates of the radius and displacements of an impedance/admittance circle, in accordance with the least one aspect of the present description.

[0076] Figures 66A to 66B are complex impedance spectra of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade, in accordance with at least one aspect of the present description, where

[0077] Figure 66A is a graphical representation of the impedance phase angle as a function of the resonance frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade; It is

[0078] Figure 66B is a graphical representation of the impedance magnitude as a function of the resonance frequency of the same ultrasonic device with a cold (blue) and hot (red) ultrasonic blade.

[0079] Figure 67 is a diagram of a Kalman filter for improving the temperature estimator and impedance-based state space model over an ultrasonic transducer measured at a range of frequencies, according to at least one aspect. of this description.

[0080] Figure 68 are three probability distributions employed by a Kalman filter state estimator shown in Figure 67 to maximize estimates, in accordance with at least one aspect of the present description.

[0081] Figure 69A is a graphical representation of the temperature as a function of time of an ultrasonic device without temperature control reaching a maximum temperature of 490°C.

[0082] Figure 69B is a graphical representation of the temperature as a function of time of an ultrasonic device with temperature control reaching a maximum temperature of 320°C, in accordance with at least one aspect of the present description.

[0083] Figures 70A to 70B are graphical representations of feedback control to adjust ultrasonic energy applied to an ultrasonic transducer when a sudden drop in the temperature of an ultrasonic blade is detected, where

[0084] Figure 70A is a graphical representation of ultrasonic energy as a function of time; It is

[0085] Figure 70B is a graph of ultrasonic blade temperature as a function of time, in accordance with at least one aspect of the present description.

[0086] Figure 71 is a logic flow diagram of a process representing a control program or a logic configuration for controlling the temperature of an ultrasonic blade, in accordance with at least one aspect of the present description.

[0087] Figure 72 is a timeline representing the situational awareness of a central surgical controller, in accordance with at least one aspect of the present description.

[0088] Figure 73 illustrates an end actuator of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0089] Figure 74 is a graph of amplitude versus time representing therapeutic cycles generated by a transducer of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0090] Figure 75A illustrates various stages of closing the end actuator of Figure 73.

[0091] Figure 75B illustrates various stages of closing the end actuator of Figure 73.

[0092] Figure 76 is a logic flow diagram of a process representing a control program or a logic configuration for selecting a power operating mode of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0093] Figure 77 is a logic flow diagram of a process representing a control program or a logic configuration for selecting a power operating mode of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0094] Figure 78 is a logic flow diagram of a process representing a control program or a logic configuration for selecting a power operating mode of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0095] Figure 78A is a schematic illustration of a tissue contact circuit showing completion of the circuit after tissue contact of a pair of closely spaced contact plates.

[0096] Figure 79 is a logic flow diagram of a process representing a control program or a logic configuration for selecting a power operating mode of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0097] Figure 80 is a schematic diagram illustrating a control circuit including an absolute positioning system, in accordance with at least one aspect of the present description.

[0098] Figure 81 is a logic flow diagram of a process representing a control program or a logic configuration for switching between power operating modes of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0099] Figure 82 is a logic flow diagram of a process depicting a control program or logic configuration for adjusting the energy applied to tissue clamped by an end actuator of an electrosurgical instrument and the energy applied to a motor of the instrument. electrosurgical based on predetermined limits of a monitored parameter, in accordance with at least one aspect of the present description.

[0100] Figure 83 is a logic flow diagram of a process representing a control program or a logic configuration for adjusting different electromechanical systems of an ultrasonic surgical instrument based on predetermined limits of a monitored parameter, according to at least one aspect of the present description.

[0101] Figure 84 is a graph representing tissue impedance (Z), power (P) and force (F) on a distal portion (tip) of an end actuator of an electrosurgical instrument that grips tissue, with tissue impedance (Z), power (P) and force (F) plotted on the Y geometric axis as a function of time (t) on the X geometric axis, in accordance with at least one aspect of the present description.

[0102] Figure 85 is a graph representing power (P) as a function of time (t) in a diagnostic mode (upper graph) and in a response mode (lower graph).

[0103] Figure 86 is a logic flow diagram of a process representing a control program or a logic configuration for detecting and compensating for the immersion of an ultrasonic blade in a liquid, in accordance with at least one aspect of the present description.

[0104] Figure 87 illustrates a graphical representation of the power (P) supplied to an end actuator and the tissue temperature as a function of a closure actuator displacement, in accordance with at least one aspect of the present description.

[0105] Figure 88 is a logic flow diagram of a process representing a control program or a logic configuration for detecting and compensating for the immersion of an ultrasonic blade in a liquid, in accordance with at least one aspect of the present description.

[0106] Figure 89 is a graph including four graphs, in which the first graph from top to bottom represents voltage (V) and current (I) as a function of time (t), the second graph represents power (P ) as a function of time (t), the third graph represents temperature (T) as a function of time (t) and the fourth graph represents tissue impedance (Z) as a function of time (t), according to at least an aspect of the present description.

[0107] Figure 90 is a logic flow diagram of a process representing a control program or logic configuration that uses tissue impedance values (Z) as trigger conditions to raise voltage (V) toward the end of a tissue treatment cycle applied to the tissue by an end actuator of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0108] Figure 91 is a logic flow diagram of a process representing a control program or logic configuration that uses temperature values (T) as trigger conditions to raise voltage (V) toward the end of a cycle of tissue treatment applied to the tissue by an end actuator of an electrosurgical instrument, in accordance with at least one aspect of the present description.

[0109] Figure 92 is a logic flow diagram of a process depicting a control program or logic configuration for adjusting the power (P) for an RF component of a combined device based on the temperature (T) monitored by a ultrasonic component of the combined device, in accordance with at least one aspect of the present description.

[0110] Figure 93 is a graph including three graphs, wherein the first graph from top to bottom represents the power (P) delivered to tissue clamped between the jaws of a bipolar RF component of a combination device, wherein the second graph represents tissue temperature as measured by an ultrasonic component of the combined device and wherein the third graph represents dual non-therapeutic frequencies employed by the ultrasonic component to determine tissue temperature, in accordance with at least one aspect of the present disclosure.

[0111] Figure 94 is a logic flow diagram of a process depicting a control program or a logic configuration for actively adjusting the RF waveform frequency of an RF electrosurgical instrument or an RF component of a combined device based on measured tissue impedance, in accordance with at least one aspect of the present disclosure.

SUMMARY OF THE INVENTION

[0112] In various embodiments, a surgical instrument comprising an end actuator comprising an ultrasonic blade and a clamping arm is described. The clamping arm is movable relative to the ultrasonic blade to transition the end actuator between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further comprises a transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein exceeding a predetermined upper limit of the parameter causes the control circuit to execute a first electromechanical system, and wherein exceeding a predetermined lower limit of the parameter causes the control circuit to execute a second electromechanical system that is different from the first electromechanical system.

[0113] In various embodiments, a surgical instrument comprising a first claw and a second claw is described. The second gripper is movable relative to the first gripper between an open configuration and a closed configuration to clamp the fabric between the first gripper and the second gripper. The surgical instrument further comprises a motor configured to move the second claw toward the closed configuration. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein reaching a predetermined upper limit of the parameter causes the control circuit to effect a change in the energy applied to the tissue, and wherein reaching a lower limit predetermined parameter causes the control circuit to make a change in the energy applied to the motor.

[0114] In various embodiments, a surgical instrument comprising an end actuator comprising an ultrasonic blade and a clamping arm is described. The clamping arm is movable relative to the ultrasonic blade to transition the end actuator between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further comprises a transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein a reading greater than or equal to a predetermined upper limit causes the control circuit to execute a first electromechanical system, and wherein a reading less than or equal to a predetermined lower limit of the parameter causes the control circuit to execute a second electromechanical system different from the first electromechanical system.

DESCRIPTION

[0115] The applicant of this application holds the following US patent applications, filed on August 28, 2018, the description of each of which is incorporated herein by reference in its entirety: • US patent application, no. docket END8536USNP2/180107-2, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; • US patent application, docket number END8560USNP2/180106-2, entitled TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR; • US patent application, docket number END8561USNP1/180144-1, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS; • US patent application, docket number END8563USNP1/180139-1, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; • US patent application, docket number END8563USNP2/180139-2, entitled CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE; • US patent application, docket number END8563USNP3/180139-3, entitled DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM; • US patent application, docket number END8563USNP4/180139-4, entitled DETERMINING THE STATE OF AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT; • US patent application, docket number END8563USNP5/180139-5, entitled DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR; • US patent application, docket number END8564USNP1/180140-1, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; • US patent application, docket number END8564USNP3/180140-3, entitled DETECTION OF END EFFECTOR IMMERSION IN LIQUID; • US patent application, docket number END8565USNP1/180142-1, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; • US patent application, docket number END8565USNP2/180142-2, entitled INCREASING RADIO FREQUENCY TO CREATE PAD-LESS MONOPOLAR LOOP; • US patent application, docket number END8566USNP1/180143-1, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and • US patent application, docket number END8573USNP1/180145-1, entitled ACTIVATION OF ENERGY DEVICES.

[0116] The applicant of this application holds the following US patent applications no., filed on August 23, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. ° 62/721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION; • US provisional patent application no. 62/721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS; • US provisional patent application no. 62/721,999, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING; • US provisional patent application no. 62/721,994, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and • US provisional patent application No. 62/721,996, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS.

[0117] The applicant of this application holds the following US patent applications, filed on June 30, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. 62/692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE; • US provisional patent application no. 62/692,748, entitled SMART ENERGY ARCHITECTURE; and • US provisional patent application No. 62/692,768, entitled SMART ENERGY DEVICES.

[0118] The applicant of this application holds the following US patent applications, filed on June 29, 2018, the description of each of which is incorporated herein by reference in its entirety: • US patent application no. series 16/024,090, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; • US Patent Application Serial No. 16/024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS; • US Patent Application Serial No. 16/024,067, entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION; • US Patent Application Serial No. 16/024,075, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; • US Patent Application Serial No. 16/024,083, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING; • US patent application serial no. 16/024,094, entitled SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES; • US Patent Application Serial No. 16/024,138, entitled SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE; • US Patent Application Serial No. 16/024,150, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES; • US Patent Application Serial No. 16/024,160, entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY; • US patent application serial no. 16/024,124, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; • US patent application serial no. 16/024,132, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT; • US Patent Application Serial No. 16/024,141, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY; • US Patent Application Serial No. 16/024,162, entitled SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES; • US patent application serial no. 16/024,066, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; • US Patent Application Serial No. 16/024,096, entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS; • US Patent Application Serial No. 16/024,116, entitled SURGICAL EVACUATION FLOW PATHS; • US Patent Application Serial No. 16/024,149, entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL; • US patent application serial no. 16/024,180, entitled SURGICAL EVACUATION SENSING AND DISPLAY; • US Patent Application Serial No. 16/024,245, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; • US Patent Application Serial No. 16/024,258, entitled SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM; • US Patent Application Serial No. 16/024,265, entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and • US Patent Application Serial No. 16/024,273, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[0119] The applicant of this application holds the following US provisional patent applications, filed on June 28, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. serial number 62/691,228, entitled A Method of using reinforced flex circuits with multiple sensors with electrosurgical devices; • US provisional patent application serial no. 62/691,227, entitled controlling a surgical instrument according to sensed closure parameters; • US provisional patent application serial no. 62/691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; • US provisional patent application serial no. 62/691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; • US provisional patent application serial no. 62/691,257, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; • US provisional patent application serial no. 62/691,262, entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and • US provisional patent application serial no. 62/691,251, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[0120] The applicant of this application holds the following US provisional patent applications, filed on April 19, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. No. 62/659,900, entitled METHOD OF HUB COMMUNICATION.

[0121] The applicant of this application holds the following provisional US patent applications, filed on March 30, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. ° 62/650,898 filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS; • US provisional patent application serial no. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES; • US provisional patent application serial no. 62/650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and • US Provisional Patent Application Serial No. 62/650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS.

[0122] The applicant of this application holds the following US patent applications, filed on March 29, 2018, the description of each of which is incorporated herein by reference in its entirety: • US patent application no. series 15/940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; • US patent application serial no. 15/940,648, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES; • US patent application serial no. 15/940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; • US patent application serial no. 15/940,666, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; • US patent application serial no. 15/940,670, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; • US patent application serial no. 15/940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS; • US Patent Application Serial No. 15/940,632, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; • US Patent Application Serial No. 15/940,640, entitled COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS; • US patent application serial no. 15/940,645, entitled SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT; • US Patent Application Serial No. 15/940,649, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME; • US patent application serial no. 15/940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS; • US patent application serial no. 15/940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING; • US patent application serial no. 15/940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; • US Patent Application Serial No. 15/940,671, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; • US Patent Application Serial No. 15/940,686, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE; • US patent application serial no. 15/940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; • US patent application serial no. 15/940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; • US Patent Application Serial No. 15/940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; • US Patent Application Serial No. 15/940,722, entitled CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and • US Patent Application Serial No. 15/940,742, entitled DUAL CMOS ARRAY IMAGING. • US patent application serial no. 15/940,636, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; • US patent application serial no. 15/940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; • US Patent Application Serial No. 15/940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; • US Patent Application Serial No. 15/940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET; • US Patent Application Serial No. 15/940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION; • US Patent Application Serial No. 15/940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; • US Patent Application Serial No. 15/940,706, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and • US Patent Application Serial No. 15/940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES. • US patent application serial no. 15/940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US Patent Application Serial No. 15/940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US patent application serial no. 15/940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US patent application serial no. 15/940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US patent application serial no. 15/940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US patent application serial no. 15/940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US patent application serial no. 15/940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and • US Patent Application Serial No. 15/940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[0123] The applicant of this application holds the following provisional US patent applications, filed on March 28, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. serial number 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; • US provisional patent application serial no. 62/649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; • US provisional patent application serial no. 62/649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; • US provisional patent application serial no. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; • US provisional patent application serial no. 62/649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; • US provisional patent application serial no. 62/649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; • US provisional patent application serial no. 62/649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; • US provisional patent application serial no. 62/649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; • US provisional patent application serial no. 62/649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; • US provisional patent application serial no. 62/649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; • US provisional patent application serial no. 62/649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES; • US provisional patent application serial no. 62/649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; • US provisional patent application serial no. 62/649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and • US provisional patent application serial no. 62/649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[0124] The applicant of this application holds the following provisional US patent applications, filed on March 8, 2018, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. serial number 62/640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and • US provisional patent application serial no. 62/640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.

[0125] The applicant of this application holds the following provisional US patent applications, filed on December 28, 2017, the description of each of which is incorporated herein by reference in its entirety: • US provisional patent application no. serial number 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM; • US provisional patent application serial no. 62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and • US provisional patent application serial no. 62/611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.

[0126] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the drawings and description attached. The illustrative examples may be implemented or incorporated in other aspects, variations and modifications, and may be practiced or performed in various ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention have been chosen for the purpose of describing the illustrative examples for the convenience of the reader and not for the purpose of limiting the same. Furthermore, it should be understood that one or more of the aspects, aspect expressions, and/or examples described below may be combined with any one or more of the other aspects, aspect expressions, and/or examples described below.

[0127] Various aspects are directed to improved ultrasonic surgical devices, electrosurgical devices and generators for use therewith. Aspects of ultrasonic surgical devices can be configured to transect and/or coagulate tissue during surgical procedures, for example. Aspects of electrosurgical devices can be configured to transect, coagulate, scale, weld, and/or desiccate tissue during surgical procedures, for example.

[0128] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., cloud 104 that may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 communicating with the cloud 104 that may include a remote server 113. In one example, as illustrated in Figure 1, the surgical system 102 includes a visualization system 108, a robotic system 110 , a handheld and intelligent surgical instrument 112, which are configured to communicate with each other and/or the central controller 106. In some aspects, a surgical system 102 may include a number of central controllers M 106, a number N of visualization systems 108, an O number of robotic systems 110, and a P number of intelligent, handheld surgical instruments 112, where M, N, O, and P are integers greater than or equal to one.

[0129] Figure 3 depicts an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in the surgical procedure as a part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient cart 120 (surgical robot), and a surgical robotic central controller 122. The patient cart 120 can handle at least one attached surgical tool removably 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124, which can be manipulated by car of the patient 120 to guide the imaging device 124. The robotic central controller 122 may be used to process images of the surgical site for subsequent display to the surgeon via the surgeon console 118.

[0130] Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present disclosure are described in provisional patent application serial no. 62/ 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, the description of which is incorporated herein by reference in its entirety.

[0131] Various examples of cloud-based analysis that are performed by cloud 104, and are suitable for use with the present disclosure, are described in US provisional patent application serial no. 62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS , deposited on December 28, 2017, the description of which is incorporated herein by reference, in its entirety.

[0132] In various aspects, imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal-oxide semiconductor (CMOS) sensors.

[0133] The optical components of the imaging device 124 may include one or more lighting sources and/or one or more lenses. One or more lighting sources can be directed to illuminate portions of the surgical field. The one or more image sensors may receive reflected or refracted light from the surgical field, including reflected or refracted light from tissue and/or surgical instruments.

[0134] The one or more lighting sources can be configured to radiate electromagnetic energy in the visible spectrum as well as the invisible spectrum. The visible spectrum, sometimes called the optical spectrum or light spectrum, is that portion of the electromagnetic spectrum that is visible to (that is, can be detected by) the human eye and may be called visible light or simply light. A typical human eye will respond to wavelengths in air that are from about 380 nm to about 750 nm.

[0135] The invisible spectrum (i.e., the non-luminous spectrum) is that portion of the electromagnetic spectrum lying below and above the visible spectrum (i.e., wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwave, radio, and electromagnetic radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.

[0136] In several aspects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use herein include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledochoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngo- neproscope, sigmoidoscope, thoracoscope, and ureteroscope.

[0137] In one aspect, the imaging device uses multiple spectrum monitoring to discriminate topography and underlying structures. A multispectral image is one that captures image data within wavelength ranges across the electromagnetic spectrum. Wavelengths can be separated by filters or through the use of instruments that are sensitive to specific wavelengths, including light of frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receptors for the colors red, green, and blue. The use of multispectral imaging is described in greater detail under the heading "Advanced Imaging Acquisition Module" in US provisional patent application serial no. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is here incorporated by reference in its entirety. Multispectral monitoring can be a useful tool for relocating a surgical field after a surgical task is completed to perform one or more of the previously described tests on the treated tissue.

[0138] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", i.e. an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes into contact with the patient or penetrates the sterile field, including the imaging device 124 and its connectors and components. It will be understood that the sterile field may be considered a specified area, such as within a tray or on a sterile towel, that is considered free of microorganisms, or the sterile field may be considered an area, immediately surrounding a patient, which was prepared for a surgical procedure. The sterile field may include grooming team members, who are appropriately attired, and all furniture and accessories in the area.

[0139] In various aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays, and one or more screens that are strategically disposed relative to the sterile field, as illustrated in Figure 2. In one aspect, the visualization system 108 includes an interface for HL7, PACS and EMR. Various components of the visualization system 108 are described under the heading "Advanced Imaging Acquisition Module" in U.S. Provisional Patent Application Serial No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is incorporated herein for reference in its entirety.

[0140] As illustrated in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. Additionally, a viewing tower 111 is positioned outside the sterile field. The viewing tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The display system 108, guided by the central controller 106, is configured to utilize screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, the central controller 106 may cause the visualization system 108 to display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while maintaining a live feed of the surgical site on the main screen 119. The snapshot on the non-sterile screen 107 or 109 may allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.

[0141] In one aspect, the central controller 106 is also configured to route diagnostic input or feedback from a non-sterile operator in the viewing tower 111 to the primary display 119 within the sterile field, where it can be viewed by a sterile operator. on the operating table. In one example, the input may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which may be routed to the main screen 119 by the central controller 106.

[0142] Referring to Figure 2, a surgical instrument 112 is being used in the surgical procedure as part of the surgical system 102. The central controller 106 is also configured to coordinate the flow of information to a display of the surgical instrument 112. For example, in US provisional patent application serial no. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is incorporated herein by reference in its entirety. A diagnostic input or feedback entered by a non-sterile operator into the viewing tower 111 may be routed by the central controller 106 to the surgical instrument display 115 in the sterile field, where it can be viewed by the surgical instrument operator 112. Exemplary surgical instruments that are Suitable for use with the Surgical System 102 are described under the heading "Surgical Instrument Hardware" and in Provisional Patent Application Serial No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is incorporated herein as a reference in its entirety, for example.

[0143] Now referring to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110, and an intelligent handheld surgical instrument 112. The central controller 106 includes a central controller display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In certain aspects, as illustrated in Figure 3, the central controller 106 further includes a smoke evacuation module 126 and/or a suction/irrigation module 128.

[0144] During a surgical procedure, the application of energy to the tissue, for sealing and/or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and/or irrigation of the tissue. Fluid, power, and/or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be lost addressing this issue during a surgical procedure. To untangle the lines it may be necessary to disconnect the lines from their respective modules, which may require a reset of the modules. The modular housing of the central controller 136 provides a unified environment for managing power, data, and fluid lines, which reduces the frequency of intertwining between such lines.

[0145] Aspects of the present description disclose a surgical hub for use in a surgical procedure involving the application of energy to tissue at a surgical site. The surgical hub includes a central controller housing and a combination generator module slidably received in a docking station of the central controller housing. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic power generating component, a bipolar RF power generating component, and a monopolar RF power generating component that are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one cable for applying power to connect the combined generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid , and/or particulates generated by the application of therapeutic energy to the tissue, and a fluid line extending from the remote surgical site to the smoke evacuation component.

[0146] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module slidably received in the central controller housing. In one aspect, the central controller housing comprises a fluidic interface.

[0147] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the tissue, while a different type of energy may be more beneficial for sealing the tissue. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which a modular central controller housing 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the central modular housing 136 is that it allows rapid removal and/or replacement of multiple modules.

[0148] Aspects of the present description present a modular surgical casing for use in a surgical procedure involving application of energy to tissue. The modular surgical cabinet includes a first power generating module configured to generate a first power for application to tissue, and a first docking station comprising a first docking port including first data contacts and power contacts, wherein the The first power generating module is slidingly movable in an electrical engagement with the power and data contacts and wherein the first power generating module is slidingly movable out of the electrical engagement with the first power and data contacts.

[0149] In addition to the foregoing, the modular surgical enclosure also includes a second energy generating module configured to generate a second energy, different from the first energy, for application to tissue, and a second docking station comprising a second docking port which includes second data and power contacts wherein the second power generating module is slidingly movable in an electrical engagement with the power and data contacts, and wherein the second power generating module is slidingly movable outwardly of the electrical coupling with the second power and data contacts.

[0150] Additionally, the modular surgical cabinet also includes a communication bus between the first docking port and the second docking port, configured to facilitate communication between the first power generating module and the second power generating module.

[0151] With reference to Figures 3 to 7, aspects of the present description are presented for a modular central controller housing 136 that allows modular integration of a generator module 140, a smoke evacuation module 126, and a suction/suction module. irrigation 128. The central modular housing 136 further facilitates interactive communication between the modules 140, 126, 128. As illustrated in Figure 5, the generator module 140 may be a generator module with integrated monopolar, bipolar and ultrasonic components supported on a single cabinet unit 139 slidingly insertable into the central modular housing 136. As illustrated in Figure 5, the generator module 140 may be configured to connect to a monopolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 may comprise a series of monopolar, bipolar and/or ultrasonic generator modules that interact through the central modular housing 136. The central modular housing 136 may be configured to facilitate the insertion of multiple generators and interactive communication between the generators anchored in the central modular housing 136 so that the generators would act as a single generator.

[0152] In one aspect, the central modular housing 136 comprises a modular power and communication backplate 149 with external and wireless communication heads to allow removable attachment of modules 140, 126, 128 and interactive communication therebetween.

[0153] In one aspect, the central modular housing 136 includes docking stations, or drawers, 151, herein also called drawers, which are configured to slidingly receive modules 140, 126, 128. Figure 4 illustrates a view in partial perspective of a surgical central controller housing 136, and a combined generator module 145 slidably received in a docking station 151 of the surgical central controller housing 136. A docking port 152 with power and data contacts on one side back of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 of the central controller modular housing 136 as the combined generator module 145 is slid into position in the station. mating module 151 of the central controller modular housing 136. In one aspect, the combined generator module 145 includes a bipolar, ultrasonic, and monopolar module and a smoke evacuation module integrated into a single housing unit 139, as illustrated in Figure 5 .

[0154] In various aspects, the smoke evacuation module 126 includes a fluid line 154 that transports captured/fluid-collected smoke away from a surgical site and to, for example, the smoke evacuation module 126. The suction The vacuum originating from the smoke evacuation module 126 can draw smoke into an opening of a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, may be in the form of a flexible tube terminating at the smoke evacuation module 126. The utility conduit and the fluid line define a fluid path extending toward the smoke evacuation module 126 which is received in the central controller housing 136.

[0155] In various aspects, the suction/irrigation module 128 is coupled to a surgical tool comprising a fluid aspiration line and a fluid suction line. In one example, the aspiration and suction fluid lines are in the form of flexible tubes extending from the surgical site toward the suction/irrigation module 128. One or more drive systems may be configured to cause irrigation to occur. and aspiration of fluids to and from the surgical site.

[0156] In one aspect, the surgical tool includes a drive shaft having an end actuator at a distal end thereof and at least one energy treatment associated with the end actuator, a suction tube, and a suction tube. irrigation. The suction tube may have an inlet port at a distal end thereof and the suction tube extends through the drive shaft. Similarly, an irrigation tube may extend through the drive shaft and may have an inlet port near the power application implement. The power delivery implement is configured to deliver ultrasonic and/or RF energy to the surgical site and is coupled to the generator module 140 by a cable initially extending through the drive shaft.

[0157] The irrigation tube may be in fluid communication with a fluid source, and the aspiration tube may be in fluid communication with a vacuum source. The fluid source and/or vacuum source may be housed in the suction/irrigation module 128. In one example, the fluid source and/or vacuum source may be housed in the central controller housing 136 separately from the fluid source module 136. suction/irrigation 128. In such an example, a fluid interface may be configured to connect the suction/irrigation module 128 to the fluid source and/or the vacuum source.

[0158] In one aspect, the modules 140, 126, 128 and/or their corresponding docking stations in the central modular housing 136 may include alignment features that are configured to align the docking ports of the mating modules with their counterparts in the stations. 4, the combined generator module 145 includes side brackets 155 that are configured to slidingly engage corresponding brackets 156 of the corresponding docking station 151 of the central modular housing 136. The brackets cooperate to guide the mating port contacts of the combined generator module 145 into an electrical engagement with the mating port contacts of the central modular housing 136.

[0159] In some aspects, the drawers 151 of the central modular housing 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side brackets 155 and/or 156 may be larger or smaller depending on the size of the module. In other aspects, the drawers 151 are different in size and are each designed to accommodate a specific module.

[0160] Additionally, the contacts of a specific module may be keyed to engage with the contacts of a specific drawer to avoid inserting a module into a drawer with contact mismatching.

[0161] As illustrated in Figure 4, the docking port 150 of a drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular housing docking ports 150 of the central modular housing 136 may alternatively or additionally facilitate wireless interactive communication between modules housed in the central modular housing 136. Any suitable wireless communication may be used, e.g. Air Titan Bluetooth.

[0162] Figure 6 illustrates individual power bus connectors for a plurality of side docking ports of a side modular compartment 160 configured to receive a plurality of modules of a surgical hub 206. The side modular compartment 160 is configured to receive and laterally interconnect the modules 161. The modules 161 are slidably inserted into the docking stations 162 of the lateral modular compartment 160, which includes a backplate for interconnecting the modules 161. As illustrated in Figure 6, the modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 may be arranged vertically in a side modular cabinet.

[0163] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 of the surgical hub 106. The modules 165 are slidably inserted into docking stations, or drawers, 167 of the vertical modular cabinet 164, which includes a back panel for interconnecting modules 165. Although the drawers 167 of the vertical modular cabinet 164 are arranged vertically, in certain cases, a vertical modular cabinet 164 may include drawers that are arranged laterally. Furthermore, the modules 165 can interact with each other through the docking ports of the vertical modular cabinet 164. In the example of Figure 7, a screen 177 is provided to show data relevant to the operation of the modules 165. Furthermore, the vertical modular compartment 164 includes a master module 178 that houses a plurality of submodules that are slidably received in the master module 178.

[0164] In various aspects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular housing that can be assembled with a light source module and a camera module. The compartment may be a disposable compartment. In at least one example, the disposable housing is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and/or camera module can be selectively chosen depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide white light or a different light depending on the surgical procedure.

[0165] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present disclosure is configured to permit replacement of a light source module or a midstream camera module during a surgical procedure, without the need to remove the imaging device from the surgical field.

[0166] In one aspect, the imaging device comprises a tubular housing that includes a plurality of channels. A first channel is configured to slidingly receive the Camera module, which can be configured for a snap-fit fit with the first channel. A second channel is configured to slidingly receive the camera module, which can be configured for a snap-fit fit with the first channel. In another example, the camera module and/or the light source module may be rotated to a final position within their respective channels. A threaded coupler can be used instead of the press fit.

[0167] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. The imaging module 138 can be configured to switch between imaging devices to provide an optimal view. In various aspects, the imaging module 138 can be configured to integrate images from different imaging devices.

[0168] Various image processors and imaging devices suitable for use with the present disclosure are described in US Patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, issued August 9, 2011, which is incorporated herein by way of reference in its entirety. Additionally, US Patent No. 7,982,776, entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from image data. Such systems can be integrated with the imaging module 138. In addition, the publication of US patent application No. 2011/0306840, entitled CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS, published on December 15, 2011, and the publication of the application US Patent No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, which are each incorporated herein by reference in their entirety.

[0169] Figure 8 illustrates a surgical data network 201 comprising a modular communications hub 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a utility facility. specially equipped for surgical operations, to a cloud-based system (e.g., cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication hub 203 comprises a network hub 207 and/or a network switch 209 communicating with a network router. The modular communications hub 203 may also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent, or switching network. A passive surgical data network serves as a conduit for data, allowing data to be transmitted from one device (or thread) to another and to cloud computing resources. An intelligent surgical data network includes features for allowing traffic to pass through the surgical data network to be monitored and for configuring each port on the network hub 207 or network switch 209. An intelligent surgical data network may be called a controllable hub or switch. A switching hub reads the destination address of each packet and then forwards the packet to the correct port.

[0170] Modular devices 1a to 1n located in the operating room may be coupled to the modular communication hub 203. The network hub 207 and/or the network switch 209 may be coupled to a network router 211 to connect the devices 1a to 1n to cloud 204 or local computer system 210. Data associated with devices 1a to 1n can be transferred to cloud-based computers via the router for remote processing and manipulation of the data. Data associated with devices 1a through 1n may also be transferred to local computer system 210 for local data processing and manipulation. Modular devices 2a at 2m located in the same operating room can also be coupled to a network switch 209. The network switch 209 can be coupled to the network hub 207 and/or the network router 211 to connect the devices 2a to 2m to cloud 204. Data associated with devices 2a to 2n may be transferred to cloud 204 via network router 211 for processing and manipulation of the data. Data associated with devices 2a to 2m may also be transferred to local computer system 210 for local data processing and manipulation.

[0171] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple network hubs 207 and/or multiple network switches 209 with multiple network routers 211. The modular communication hub 203 can be contained in a modular control tower configured to receive multiple devices 1a to 1n/2a to 2m. The local computer system 210 may also be contained in a modular control tower. The modular communication hub 203 is connected to a screen 212 to display images obtained by some of the devices 1a to 1n/2a to 2m, for example, during surgical procedures. In various aspects, devices 1a to 1n/2a to 2m may include, for example, various modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to a power-based surgical device, an evacuation module smoke filter 126, a suction/irrigation module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device coupled to a display, and/or a contactless sensor module, among others modular devices that can be connected to the modular communication hub 203 of the surgical data network 201.

[0172] In one aspect, the surgical data network 201 may comprise a combination of network hubs, network switches, and network routers that connect devices 1a to 1n/2a to 2m to the cloud. Any or all of the 1a to 1n/2a to 2m devices coupled to the network hub or network switch can collect real-time data and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing relies on sharing computing resources rather than having local servers or personal devices to handle software applications. The word "cloud" can be used as a metaphor for "the Internet", although the term is not limited as such. Consequently, the term "cloud computing" can be used here to refer to "a type of Internet-based computing" in which different services — such as servers, storage, and applications — are applied to the modular communications hub 203 and/or or to the computer system 210 located in the operating room (e.g., a fixed, mobile, temporary room or space, or operating field) and to devices connected to the modular communication hub 203 and/or the computer system 210 via the Internet . Cloud infrastructure can be maintained by a cloud service provider. In this context, the cloud service provider may be the entity that coordinates the use and control of the 1a to 1n/2a to 2m devices located in one or more operating rooms. Cloud computing services can perform a large number of calculations based on data collected by intelligent surgical instruments, robots, and other computerized devices located in the operating room. Hub hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.

[0173] Applying cloud computer data processing techniques to the data collected by devices 1a to 1n/2a to 2m, the surgical data network provides better surgical results, reduced costs, and improved patient satisfaction. At least some of the devices 1a to 1n/2a to 2m can be used to visualize tissue states to assess the occurrence of leaks or perfusion of sealed tissue following a tissue sealing and cutting procedure. At least some of the devices 1a to 1n/2a to 2m can be used to identify pathology, such as the effects of disease, using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes confirmation of tissue location and margin and phenotypes. At least some of the devices 1a to 1n/2a to 2m can be used to identify anatomical structures of the body using a variety of sensors integrated with imaging devices and techniques such as superimposing images captured by multiple imaging devices. Data collected by devices 1a to 1n/2a to 2m, including image data, may be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, precise robotics to specific tissue sites and conditions, can be followed. This data analysis can further use analytical processing of the results, and with the use of standardized approaches can provide beneficial standardized feedback to either confirm surgical treatments and surgeon behavior or suggest modifications to surgical treatments and surgeon behavior.

[0174] In one implementation, operating room devices 1a to 1n may be connected to the modular communications hub 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1n on a network hub. The network hub 207 may be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI ("open system interconnection") model. The network hub provides connectivity to devices 1a through 1n located on the same network as the operating room. Network hub 207 collects data in the form of packets and sends it to the router in half-duplex mode. Network hub 207 does not store any media access control/Internet Protocol (MAC/IP) to transfer data. Only one of devices 1a through 1n at a time can send data through the network hub 207. The network hub 207 has no routing tables or intelligence about where to send information and transmits all network data through each device. connection and to a remote server 213 (Figure 9) in the cloud 204. The network hub 207 can detect basic network errors such as collisions, but having all (admit) information transmitted to multiple input ports may be a security risk. safety and cause strangulation.

[0175] In another implementation, operating room devices 2a to 2m may be connected to a network switch 209 via a wired or wireless channel. Network key 209 works at the data connection layer of the OSI model. Network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network switch 209 sends data in the form of frames to the network router 211 and operates in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network switch 209. Network switch 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.

[0176] Network hub 207 and/or network switch 209 are coupled to network router 211 for a connection to cloud 204. Network router 211 functions at the network layer of the OSI model. The network router 211 creates a route to transmit data packets received from the network hub 207 and/or the network switch 211 to a computer with cloud capabilities for further processing and manipulation of the data collected by any or all of the devices. 1a to 1n/ 2a to 2m. Network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms of the same healthcare facility or different networks located in different operating rooms of different healthcare facilities. of health. The network router 211 sends data in the form of packets to the cloud 204 and operates in full duplex mode. Multiple devices can send data at the same time. Network router 211 uses IP addresses to transfer data.

[0177] In one example, the network hub 207 can be implemented as a USB hub, which allows multiple USB devices to be connected to a host computer. The USB hub can expand a single USB port by multiple levels so that there are more ports available for connecting devices to the system's host computer. The network hub 207 may include wired or wireless capabilities for receiving information about a wired channel or a wireless channel. In one aspect, a wireless, broadband, short-range USB wireless radio communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m situated in the operating room.

[0178] In other examples, operating room devices 1a to 1n/2a to 2m may communicate with the modular communication hub 203 via standard wireless Bluetooth technology to exchange data over short distances (with the using short-wavelength UHF radio waves in the ISM band 2.4 to 2.485 GHz) from fixed and mobile devices and building personal area networks (PANs). In other aspects, operating room devices 1a to 1n/2a to 2m may communicate with the modular communication hub 203 via a number of wireless and wired communication standards or protocols, including but not limited to , Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE), and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computing module may include a plurality of communication modules. For example, a first communication module may be dedicated to short-range wireless communications such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to longer-range wireless communications such as GPS, EDGE, GPRS, CDMA , WiMAX, LTE, Ev-DO, and others.

[0179] The modular communications hub 203 can serve as a central connection for one or all of the operating room devices 1a to 1n/2a to 2m and handles a type of data known as frames. The frames carry data generated by devices 1a to 1n/2a to 2m. When a frame is received by the modular communication hub 203, it is amplified and transmitted to the network router 211, which transfers the data to cloud computing resources using a series of wireless communication standards or protocols or wired, as described in the present invention.

[0180] The modular communication hub 203 can be used as a stand-alone device or be connected to compatible network hubs and network switches to form a larger network. The 203 modular communications hub is generally easy to install, configure and maintain, making it a good choice for networking 1a to 1n/2a devices within 2m of the operating room.

[0181] Figure 9 illustrates a computer-implemented interactive surgical system 200. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system per computer 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one surgical hub 206 in communication with a cloud 204 that may include a remote server 213. In one aspect , the computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices, such as intelligent surgical instruments, robots, and other computerized devices located in the operating room. As shown in Figure 10, the modular control tower 236 comprises a modular communications hub 203 coupled to a computer system 210. As illustrated in the example of Figure 9, the modular control tower 236 is coupled to an imaging module 238 that is coupled to an endoscope 239, a generator module 240 that is coupled to a power device 241, a smoke evacuation module 226, a suction/irrigation module 228, a communication module 230, a processor module 232, a storage array 234, a smart device/instrument 235 optionally coupled to a display 237, and a contactless sensor module 242. The operating room devices are coupled to cloud computing resources and data storage via the storage tower. modular control 236. The robot hub 222 can also be connected to the modular control tower 236 and cloud computing resources. Devices/Instruments 235, visualization systems 208, among others, can be coupled to the modular control tower 236 through wired or wireless communication standards or protocols, as described in the present invention. The modular control tower 236 may be coupled to a hub screen 215 (e.g., monitor, screen) to display and overlay images received from the imaging module, device/instrument screen, and/or other display systems 208. The screen The hub can also display data received from devices connected to the modular control tower together with images and overlaid images.

[0182] Figure 10 illustrates a surgical hub 206 comprising a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a modular communications hub 203, e.g., a network connectivity device, and a computer system 210 for providing local processing, visualization, and imaging, for example. As shown in Figure 10, the modular communications hub 203 may be connected in a layered configuration to expand the number of modules (e.g., devices) that may be connected to the modular communications hub 203 and transfer data associated with the modules to the computer system 210, cloud computing resources, or both. As shown in Figure 10, each of the network hubs/switches in the modular communication hub 203 includes three downstream ports and one upstream port. The upstream network hub/switch is connected to a processor to provide a communication connection to cloud computing resources and a local display 217. Communication with the cloud 204 may be done via a wired communication channel or wireless.

[0183] The surgical hub 206 uses a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using laser or ultrasonic type non-contact measuring devices. An ultrasound-based contactless sensor module scans the operating room by transmitting an ultrasound burst and receiving the echo when it bounces off the perimeter of an operating room walls, as described under the heading Surgical Hub Spatial Awareness Within an Operating Room" in US provisional patent application serial no. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is incorporated herein by reference in its entirety, in which the sensor module is configured to determine the size of the operating room and adjust Bluetooth pairing distance limits. A laser-based contactless sensor module scans the operating room transmitting pulses of laser light, receiving pulses of laser light that bounce off the perimeter walls. of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust Bluetooth pairing distance limits, for example.

[0184] Computer system 210 comprises a processor 244 and a network interface 245. The processor 244 is coupled to a communications module 247, storage 248, memory 249, non-volatile memory 250, and input/output interface 251 through of a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and/or a local bus that uses any variety of available bus architectures including, but not limited to, not limited to, 9-bit bus, Industry Standard Architecture (ISA), Micro-Charmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Component Interconnect peripherals (PCI), USB, accelerated graphics port (AGP), PCMCIA (Personal Computer Memory Card International Association) bus, Small Computer Systems Interface (SCSI), or any another proprietary bus.

[0185] Processor 244 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex available from Texas Instruments. In one aspect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz. , a look-ahead buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, 2 KB electrically erasable programmable readout (EEPROM), one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder inputs (QEI), one or more analog to digital converters (ADC) 12-bit with 12 analogue input channels, details of which are available in the product datasheet.

[0186] In one aspect, the processor 244 may comprise a security controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety-critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity, and memory options.

[0187] System memory includes volatile memory and non-volatile memory. The basic input/output system (BIOS), containing the basic routines for transferring information between elements within the computer system, such as during startup, is stored in non-volatile memory. For example, non-volatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory includes random access memory (RAM), which acts as external cache memory. Furthermore, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM. Rambus RAM (DRRAM).

[0188] Computer system 210 also includes removable/non-removable, volatile/non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zip drive, LS-60 drive, flash memory card, or memory stick. drive). Additionally, the storage disk may include storage media separately or in combination with other storage media including, but not limited to, an optical disk drive such as a compact disk ROM device (CD-ROM) compact disk drive recordable (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a digital versatile disk ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.

[0189] It is to be understood that computer system 210 includes software that acts as an intermediary between users and the basic computer capabilities described in a suitable operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from management capabilities by the operating system through program modules and program data stored in system memory or disk storage. It is to be understood that various components described in the present invention can be implemented with various operating systems or combinations of operating systems.

[0190] A user enters commands or information into computer system 210 through input device(s) coupled to I/O interface 251. Input devices include, but are not limited to, a device pointer such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices connect to the processor via the system bus through the interface port(s). Interface ports include, for example, a serial port, a parallel port, a game port, and a USB. Output devices use some of the same types of ports as input devices. Thus, for example, a USB port can be used to provide input to the computer system and to provide information from the computer system to an output device. An output adapter is provided to illustrate that there are some output devices such as monitors, screens, speakers, and printers, among other output devices, that require special adapters. Output adapters include, by way of illustration and not limitation, video and sound cards that provide a means of connection between the output device and the system bus. It should be noted that other devices and/or device systems, such as remote computers, provide input and output capabilities.

[0191] Computer system 210 may operate in a networked environment using logical connections with one or more remote computers, such as cloud computers, or local computers. Remote cloud computers may be a personal computer, server, router, network personal computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include many or all of the elements described in relation to the computer system. For brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system through a network interface and then physically connected through a communications connection. The network interface encompasses communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include Fiber Distributed Data Interface (FDDI), Copper Distributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE 802.5, and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as integrated services digital networks (ISDN) and variations thereof, packet-switched networks, and digital subscriber lines (DSL).

[0192] In various aspects, the computer system 210 of Figure 10, the imaging module 238 and/or display system 208, and/or the processor module 232 of Figures 9 to 10, may comprise an image processor, image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images. The image processor can employ parallel computing with single instruction multiple data (SIMD) or multiple instruction multiple data (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor may be a system on an integrated circuit with multi-core processor architecture.

[0193] Communication connections refer to the hardware/software used to connect the network interface to the bus. Although the communications connection is shown for illustrative clarity within the computer system, it may also be external to the computer system 210. The hardware/software required for connection to the network interface includes, for illustrative purposes only, internal and external technologies. such as modems, including regular telephone series modems, cable modems and DSL modems, ISDN adapters and Ethernet cards.

[0194] Figure 11 illustrates a functional block diagram of an aspect of a USB network hub device 300, in accordance with at least one aspect of the present description. In the illustrated appearance, the USB 300 network hub device uses a TUSB2036 integrated circuit hub available from Texas Instruments. The USB network hub 300 is a CMOS device that provides one upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, 308 in compliance with the USB 2.0 specification. The upstream USB transceiver port 302 is a differential data root port comprising a "minus" differential data input (DM0) paired with a "plus" differential data input (DP0). The three downstream USB transceiver ports 304, 306, 308 are differential data ports, where each port includes "plus" differential data outputs (DP1-DP3) paired with "minus" differential data outputs (DM1-DM3). .

[0195] The USB network hub device 300 is implemented with a digital state machine instead of a microcontroller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuitry for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed or low speed by automatically configuring the scan rate according to the speed of the device attached to the ports. The USB network hub device 300 can be configured in bus-powered or self-powered mode and includes a core power logic 312 to manage power.

[0196] The USB network hub device 300 includes a serial interface engine 310 (SIE). The SIE 310 is the hardware front end of the USB 300 network hub and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection/generation, clock/data separation, non-reverse-zero data encoding/decoding (NRZI) , CRC (token and data) generation and verification, packet ID (PID) generation and verification/decoding, and/or series-to-parallel/parallel-to-series conversion. 310 receives a clock input 314 and is coupled to a suspend/resume and frame timer logic circuit 316 and a central controller replay circuit 318 to control communication between the upstream USB transceiver port 302 and the USB transceiver ports. downstream 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through the logic interface to control commands from a series EEPROM through a serial EEPROM interface. 330 series.

[0197] In various aspects, the USB network hub 300 can connect 127 functions configured in up to six logical layers (levels) to a single computer. Additionally, the USB 300 network hub can connect all peripherals using a standardized four-wire cable that provides both communication and power distribution. The power settings are bus-powered and self-powered modes. The USB 300 network hub can be configured to support four power management modes: a bus-powered hub, with individual port power management or grouped port power management, and the self-powered hub, with port power management individual or grouped port power management. In one aspect, using a USB cable, the USB network hub 300, the upstream USB transceiver port 302 is plugged into a USB host controller, and the downstream USB transceiver ports 304, 306, 308 are exposed for connecting compatible USB devices, and so on.

Surgical Instrument Hardware

[0198] Figure 12 illustrates a logical diagram of a module of a control system 470 of a surgical instrument or tool, in accordance with one or more aspects of the present description. System 470 comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory 468. One or more of sensors 472, 474, 476, for example, provide real-time feedback to the processor 462. A motor 482, driven by a driver of motor 492, operatively couples a longitudinally movable displacement member to drive a clamping arm of the closing member. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. Position information is provided to processor 462, which can be programmed or configured to determine the position of the longitudinally movable drive member as well as the position of the closure member. Additional motors may be provided at the tool driver interface to control the tube closing trajectory, drive shaft rotation, pivoting, or clamping arm closing, or a combination thereof. A screen 473 displays a variety of instrument operating conditions and may include touch screen functionality for data entry. Information displayed on screen 473 may be overlaid with images captured through endoscopic imaging modules.

[0199] In one aspect, the microcontroller 461 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex available from Texas Instruments. In one aspect, the main microcontroller 461 may be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, which comprises an integrated memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a look-ahead buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, memory 2 KB programmable and erasable electrically read-only (EEPROM), one or more pulse width modulation (PWM) modules, one or more analogue quadrature encoder inputs (QEI), and/or one or more analog converters to 12-bit digital (ADC) with 12 analog input channels, details of which are available in the product datasheet.

[0200] In one aspect, the microcontroller 461 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x known under the trade name Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety-critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity, and memory options.

[0201] The microcontroller 461 can be programmed to perform various functions such as precisely controlling the speed and position of the scalpel, the articulation systems, the clamping arm, or a combination thereof. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 may be a brushed direct current (DC) motor with a gearbox and mechanical connections with a linkage or scalpel system. In one aspect, a motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. Other motor drivers may be readily substituted for use in the tracking system 480 comprising an absolute positioning system. A detailed description of an absolute positioning system is provided in US Patent Application Publication No. 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published October 19, 2017, which is incorporated herein into reference title in its entirety.

[0202] The microcontroller 461 can be programmed to provide precise control of the speed and position of the travel members and linkage systems. The microcontroller 461 may be configured to compute a response in the microcontroller 461 software. The computed response is compared to a measured response of the real system to obtain an "observed" response, which is used for actual feedback-based decisions. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences on the system.

[0203] In one aspect, the motor 482 may be controlled by the motor driver 492 and may be used by the firing system of the instrument or surgical tool. In various forms, motor 482 may be a brushed direct current (DC) drive motor, with a maximum rotational speed of approximately 25,000 RPM, for example. In other arrangements, the motor 482 may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor, or any other suitable type of electric motor. Motor driver 492 may comprise an H-bridge driver comprising field effect transistors (FETs), for example. Motor 482 may be powered by a power assembly releasably mounted in the grip assembly or tool housing to provide control power to the instrument or surgical tool. The power supply assembly may comprise a battery that may include a plurality of battery cells connected in series, which may be used as the power source to power the instrument or surgical tool. In certain circumstances, the power pack battery cells may be replaceable and/or rechargeable battery cells. In at least one example, the battery cells may be lithium-ion batteries that may be attachable and separable from the power pack.

[0204] The 492 motor driver may be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 driver is a full bridge controller for use with external power semiconductor metal oxide field effect transistors (MOSFET). , N-channel, specifically designed for inductive loads such as brushed DC motors. The 492 driver comprises a unique charge pump regulator that provides full gate drive (>10 V) for batteries with voltages up to 7 V and allows the A3941 to operate with reduced gate drive, up to 5.5 V. A capacitor input drive can be used to supply the battery-in excess voltage required for the N-channel MOSFETs. An internal charge pump for the top-side drive allows direct current operation (100% duty cycle). The entire bridge can be driven in fast or slow drop modes using diodes or synchronized rectification. In slow drop mode, current recirculation can occur through the upper and lower FETs. The power FETs are protected from the shoot-through effect by means of resistors with programmable dead time. Built-in diagnostics provide indication of undervoltage, overtemperature, and power bridge failures and can be configured to protect power MOSFETs under most short circuit conditions. Other motor drives can be readily substituted for use in the tracking system 480 comprising an absolute positioning system.

[0205] The tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472 in accordance with an aspect of the present description. Position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a moving member. In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement meshed with a corresponding drive gear of a gear reducer assembly. In other aspects, the displacement member represents the firing member, which may be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a longitudinal displacement member for opening and closing a clamping arm, which may be adapted and configured to include a rack of drive teeth. In other aspects, the displacement member represents a clamping arm closing member configured to close and open a clamping arm of a stapler, ultrasonic, or electrosurgical device, or combinations thereof. Accordingly, as used in the present invention, the term displacement member is used generically to refer to any movable member of the instrument or surgical tool such as the drive member, the gripping arm, or any element that can be displaced. Consequently, the absolute positioning system can, in effect, track the displacement of the clamping arm by tracking the linear displacement of the longitudinally movable drive member.

[0206] In other aspects, the absolute positioning system may be configured to track the position of a clamping arm in the opening or closing process. In various other aspects, the displacement member may be coupled to any position sensor 472 suitable for measuring linear displacement. In this way, the longitudinally movable drive member, or clamping arm, or combinations thereof, can be coupled to any linear displacement sensor. Linear displacement sensors may include contact or non-contact displacement sensors. Linear displacement sensors may comprise Linear Variable Differential Transformers (LVDT), Differential Variable Reluctance Transducers (DVRT), a potentiometer, a magnetic detection system comprising a movable magnet and a linearly arranged array of Hall Effect Sensors, a magnetic detection system comprising a fixed magnet and a series of movable, linearly arranged Hall Effect Sensors, a movable optical detection system comprising a moving light source and a series of linearly arranged photodiodes or photodetectors, an optical detection system that comprises a fixed light source and a movable series of linearly arranged photodiodes or photodetectors, or any combination thereof.

[0207] The electric motor 482 may include a rotating drive shaft, which operatively interfaces with a gear assembly, which is mounted in coupling engagement with a set or rack of drive teeth on the drive member. A sensing element may be operatively coupled to a gear assembly such that a single revolution of the position sensing element 472 corresponds to some linear longitudinal translation of the displacement member. An arrangement of gears and sensors may be connected to the linear actuator through a rack and pinion arrangement, or to a rotary actuator, through a toothed wheel or other connection. A power supply provides power to the absolute positioning system, and an output indicator can display the output of the absolute positioning system. The drive member represents the longitudinally movable drive member comprising a rack of drive teeth formed thereon for mesh engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable firing member for opening and closing a clamping arm.

[0208] A single revolution of the sensing element associated with position sensor 472 is equivalent to a longitudinal linear displacement of d1 of the displacement member, where d1 represents the longitudinal linear distance by which the displacement member moves from point "a" to point "b" after a single revolution of the sensing element coupled to the displacement member. The sensor arrangement may be connected via a gear reduction that results in the position sensor 472 completing one or more revolutions for the full stroke of the travel member. The position sensor 472 can complete multiple revolutions for the full stroke of the displacement member.

[0209] A series of switches, where n is an integer greater than one, may be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the position sensor 472. The state of the switches is transmitted back to the microcontroller 461 which applies logic to determine a single position signal corresponding to the longitudinal linear displacement of di + d2 + ... dn of the displacement member. The output of the position sensor 472 is provided to the microcontroller 461. In various embodiments, the position sensor 472 of the sensor array may comprise a magnetic sensor, an analog rotary sensor such as a potentiometer, or a series of analog Hall effect elements. , which output a unique combination of position signals or values.

[0210] The position sensor 472 may comprise any number of magnetic sensing elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors span many aspects of physics and electronics. Technologies used for magnetic field detection include flowmeter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piesoelectric compounds, magnetodiode, magnetic transistor, fiber optics, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.

[0211] In one aspect, the position sensor 472 for the tracking system 480 comprising an absolute positioning system comprises a magnetic rotary absolute positioning system. The 472 position sensor can be implemented as a single integrated circuit, magnetic, rotary position sensor, AS5055EQFT, available from Austria Microsystems, AG, Austria. The position sensor 472 interfaces with the microcontroller 461 to provide an absolute positioning system. The position sensor 472 is a low voltage, low power component and includes four effect elements in an area of the position sensor 472 located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC processor (digital computer for coordinate rotation), also known as the digit-by-digit method and Volder's algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, shift operations bits and lookup table. The angle position, alarm bits, and magnetic field information are transmitted through a standard serial communications interface, such as a serial peripheral interface (SPI), to the microcontroller 461. The position sensor 472 provides 12 or 14 bits of resolution. The 472 position sensor can be an AS5055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4x4x0.85 mm.

[0212] The tracking system 480 comprising an absolute positioning system may comprise and/or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller. A power supply converts the feedback controller signal into a physical input to the system, in this case voltage. Other examples include a voltage, current, and power PWM. Other sensors may be provided to measure parameters of the physical system in addition to the position measured by position sensor 472. In some aspects, the other sensors may include sensor arrangements as described in US Patent No. 9,345,481 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, granted May 24, 2016, which is incorporated by reference in its entirety herein; US Patent Application Serial No. 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published September 18, 2014, is incorporated by reference in its entirety herein; and US Patent Application Serial No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety herein. In a digital signal processing system, an absolute positioning system is coupled to a digital data capture system where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system may comprise a comparison and combination circuit for combining a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that drive the calculated response toward the measured response. The computed response to the physical system considers properties such as mass, inertia, viscous friction, inductance resistance, etc., to predict from knowledge of the input what the states and outputs of the physical system will be.

[0213] The absolute positioning system provides absolute positioning of the displaced member upon activation of the instrument without having to retract or advance the longitudinally movable actuation member to the reset (zero or home) position, as may be required by encoders conventional rotary devices that merely count the number of progressive or regressive steps that the motor 482 has traveled to infer the position of an actuator device, drive bar, scalpel, and the like.

[0214] A sensor 474, such as, for example, a strain gauge or a microstress gauge, is configured to measure one or more parameters of the end actuator, such as, for example, the amplitude of the strain exerted on the anvil during a grasping operation, which may be indicative in relation to tissue compression. The measured effort is converted into a digital signal and provided to processor 462. Alternatively, or in addition to sensor 474, a sensor 476, such as a load sensor, can measure the closing force applied by the drive system. closure to the anvil on a stapler or a clamping arm on an electrosurgical or ultrasonic instrument. The sensor 476, such as a load sensor, may measure the triggering force applied to a closure member coupled to a clamping arm of the instrument or surgical tool or the force applied via a clamping arm to the tissue. located in the jaws of an electrosurgical or ultrasonic instrument. Alternatively, a current sensor 478 may be used to measure the current drawn by the motor 482. The displacement member may also be configured to engage a clamping arm to open or close the clamping arm. The force sensor can be configured to measure the gripping force on the fabric. The force required to advance the displacement member may correspond to the current drawn by motor 482, for example. The measured force is converted into a digital signal and supplied to the 462 processor.

[0215] In one form, a strain measuring sensor 474 can be used to measure the force applied to the fabric by the end actuator. A strain gauge may be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to tissue secured by the end actuator comprises a strain gauge sensor 474, such as, for example, a microstrain meter, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the strain gauge sensor 474 may measure the amplitude or magnitude of mechanical stress exerted on a gripper member of an end actuator during a grasping operation, which may be indicative of tissue compression. The measured effort is converted into a digital signal and provided to the processor 462 of a microcontroller 461. A load sensor 476 can measure the force used to operate the knife element, for example, to cut tissue captured between the anvil and the cartridge. of staples. A load sensor 476 can measure the force used to operate the gripping arm member, for example, to capture tissue between the gripping arm and an ultrasonic blade or to capture tissue between the gripping arm and a gripper of a electrosurgical instrument. A magnetic field sensor can be used to measure the thickness of captured tissue. The magnetic field sensor measurement can also be converted to a digital signal and provided to the 462 processor.

[0216] Measurements of tissue compression, tissue thickness, and/or force required to close the end actuator to the tissue, as respectively measured by sensors 474, 476, may be used by microcontroller 461 to characterize the selected position of the firing member and/or the corresponding velocity value of the firing member. In one case, a memory 468 may store a technique, an equation, and/or a look-up table that may be used by the microcontroller 461 in evaluation.

[0217] The control system 470 of the surgical instrument or tool may also comprise wired or wireless communication circuitry for communicating with the modular communication hub shown in Figures 8 to 11.

[0218] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool in accordance with an aspect of the present description. Control circuit 500 may be configured to implement various processes described herein. Control circuit 500 may comprise a microcontroller comprising one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one memory circuit 504. Memory circuit 504 stores machine-executable instructions that, when executed by the processor 502, cause processor 502 to execute machine instructions to implement various of the processes described herein. Processor 502 may be any of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. The processor 502 may include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

[0219] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool in accordance with an aspect of the present description. Combinational logic circuit 510 may be configured to implement various processes described herein. The combinational logic circuit 510 may comprise a finite state machine comprising a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by the combinational logic 512, and provide an output 516.

[0220] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the instrument or surgical tool in accordance with an aspect of the present description. Sequential logic circuit 520 or combinational logic 522 may be configured to implement the process described herein. The sequential logic circuit 520 may comprise a finite state machine. The sequential logic circuit 520 may comprise a combinational logic 522, at least one memory circuit 524, a clock 529, and, for example. The at least one memory circuit 524 may store a current state of the finite state machine. In certain cases, the sequential logic circuit 520 may be synchronous or asynchronous. Combinational logic 522 is configured to receive data associated with the instrument or surgical tool from an input 526, process the data by combinational logic 522, and provide an output 528. In other aspects, the circuit may comprise a combination of a processor (e.g. , processor 502, Figure 13) and a finite state machine for implementing various processes of the present invention. In other aspects, the finite state machine may comprise a combination of a combinational logic circuit (e.g., a combinational logic circuit 510, Figure 14) and the sequential logic circuit 520.

[0221] Figure 16 illustrates a surgical instrument or tool comprising a plurality of motors that can be activated to perform various functions. In certain cases, a first engine may be activated to perform a first function, a second engine may be activated to perform a second function, a third engine may be activated to perform a third function, a fourth engine may be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 may be individually activated to cause firing, closing, and/or pivoting movements in the end actuator. The firing, closing and/or articulation movements can be transmitted to the end actuator through a drive shaft assembly, for example.

[0222] In certain cases, the surgical instrument or tool system may include a trigger motor 602. The trigger motor 602 may be operatively coupled to a trigger motor drive assembly 604, which may be configured to transmit motion firing, generated by motor 602 to the end actuator, particularly to move the closing member of the clamping arm. The closing member can be retracted by reversing the direction of the motor 602, which also causes the clamping arm to open.

[0223] In certain instances, the surgical instrument or tool may include a closing motor 603. The closing motor 603 may be operatively coupled to a closing motor drive assembly 605 that may be configured to transmit closing movements, generated by motor 603 to the end actuator, particularly to move a closing tube to close the anvil and compress the tissue between the anvil and the staple cartridge. The closing motor 603 may be operatively coupled to a closing motor drive assembly 605 that may be configured to transmit closing movements generated by the motor 603 to the end actuator, particularly to move a closing tube to close the closing arm. clamping and compressing tissue between the clamping arm and an ultrasonic blade or the clamping arm or gripper member of an electrosurgical device. Closing movements can cause the end actuator to transition from an open configuration to a rough configuration to capture tissue, for example. The end actuator can be transitioned to an open position by reversing the direction of the motor 603.

[0224] In certain cases, the surgical instrument or tool may include one or more joint motors 606a, 606b, for example. Motors 606a, 606b may be operatively coupled to linkage motor drive assemblies 608a, 608b, which may be configured to transmit linkage movements generated by motors 606a, 606b to the end actuator. In certain cases, pivoting movements may cause the end actuator to be pivoted relative to the drive shaft assembly, for example.

[0225] As described above, the surgical instrument or tool may include a plurality of motors that may be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool may be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the linkage motors 606a, 606b may be activated to cause the end actuator to be articulated, while the trigger motor 602 remains inactive. Alternatively, the firing motor 602 may be activated to fire the plurality of staples, and/or advance the cutting edge, while the linkage motor 606 remains inactive. Furthermore, the closure motor 603 may be activated simultaneously with the trigger motor 602 to cause the closure tube or closure member to advance distally as described in more detail later in this document.

[0226] In certain cases, the surgical instrument or tool may include a common control module 610 that may be used with a plurality of motors of the surgical instrument or tool. In certain cases, the common control module 610 may accommodate one of the plurality of motors at a time. For example, the common control module 610 may be attachable to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of motors of the instrument or surgical tool may share one or more common control modules, such as common control module 610. In certain cases, a plurality of motors of the instrument or surgical tool may be individually and selectively engaged to the common control module 610. In certain cases, the common control module 610 may be selectively switched between interfacing with one of a plurality of motors of the instrument or surgical tool to interfacing with another of the plurality of motors of the instrument or surgical tool.

[0227] In at least one example, the common control module 610 may be selectively switched between operational engagement with linkage motors 606a, 606B, and operational engagement with firing motor 602 or closing motor 603. In In at least one example, as illustrated in Figure 16, a switch 614 may be moved or transitioned between a plurality of positions and/or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trigger motor 602; in a second position 617, the switch 614 may electrically couple the control module 610 to the closing motor 603; in a third position 618a, the switch 614 may electrically couple the common control module 610 to the first linkage motor 606a; and in a fourth position 618b, the switch 614 may electrically couple the common control module 610 to the second linkage motor 606b, for example. In certain cases, separate common control modules 610 may be electrically coupled to the firing motor 602, the closing motor 603, and the linkage motors 606a, 606b at the same time. In certain cases, the switch 614 may be a mechanical switch, an electromechanical switch, a solid state switch, or any suitable switching mechanism.

[0228] Each of the motors 602, 603, 606a, 606b may comprise a torque sensor for measuring the output torque on the motor drive shaft. The force on an end actuator can be sensed in any conventional way, such as by means of force sensors on the outer sides of the grippers or by a torque sensor on the motor that drives the grippers.

[0229] In various cases, as illustrated in Figure 16, the common control module 610 may comprise a motor driver 626 that may comprise one or more H-Bridge FETs. The motor driver 626 may modulate power transmitted from a power supply 628 to a motor coupled to the common control module 610, based on an input from a microcontroller 620 (the "controller"), for example. In certain cases, the microcontroller 620 may be used to determine the current drawn by the motor, for example, while the motor is coupled to the common control module 610, as described above.

[0230] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or memory units 624 (the "memory"). In certain cases, memory 624 may store various program instructions that, when executed, may cause processor 622 to perform a plurality of functions and/or calculations described herein. In certain cases, one or more of the memory units 624 may be coupled to the processor 622, for example. In various aspects, the microcontroller 620 may communicate over a wired or wireless channel, or combinations thereof.

[0231] In certain cases, the power supply 628 may be used to provide power to the microcontroller 620, for example. In certain cases, the power source 628 may comprise a battery (or "battery pack" or "power source"), such as a Li-ion battery, for example. In certain cases, the battery pack may be configured to be releasably mounted to the handle to provide power to the surgical instrument 600. Multiple battery cells connected in series may be used as the power source 628. In certain cases, the battery power supply 628 may be replaceable and/or rechargeable, for example.

[0232] In various cases, the processor 622 may control the motor driver 626 to control the position, direction of rotation, and/or speed of a motor that is coupled to the common control module 610. In certain cases, the processor 622 may signal motor driver 626 to stop and/or disable a motor that is coupled to common control module 610. It should be understood that the term "processor" as used herein includes any microprocessor, microcontroller, or other control device. Proper basic computing that incorporates the functions of a computer central processing unit (CPU) on an integrated circuit or, at most, a few integrated circuits. The 622 processor is a multipurpose programmable device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.

[0233] In one example, processor 622 may be any single-core or multi-core processor, such as those known by the trade name ARM Cortex from Texas Instruments. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single-cycle flash-type memory or other non-volatile memory, up to 40 MHz, a look-ahead buffer for optimize performance above 40 MHz, a 32 KB single-cycle SRAM, an internal ROM loaded with StellarisWare® software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more ADCs 12-bit with 12 analog input channels, among other features that are readily available in the product data sheet. Other microcontrollers can be readily substituted for use with the 4410 module. Accordingly, the present description should not be limited in this context.

[0234] In certain cases, memory 624 may include program instructions for controlling each of the motors of surgical instrument 600 that are attachable to common control module 610. For example, memory 624 may include program instructions for controlling the motor trigger 602, the closing motor 603 and the articulation motors 606a, 606b. Such program instructions may cause the processor 622 to control the triggering, closing, and articulation functions in accordance with inputs from the control algorithms or programs of the instrument or surgical tool.

[0235] In certain cases, one or more mechanisms and/or sensors, such as sensors 630, may be used to alert processor 622 to program instructions that need to be used in a specific configuration. For example, sensors 630 may alert processor 622 to use program instructions associated with triggering, closing, and articulating the end actuator. In certain cases, the sensors 630 may comprise position sensors that may be used to detect the position of the switch 614, for example. Accordingly, the processor 622 may use the program instructions associated with triggering the closure member coupled to the clamping arm of the end actuator upon detecting, through the sensors 630, for example, that the switch 614 is in the first position 616; the processor 622 may use the program instructions associated with closing the anvil upon detection through the sensors 630, for example, that the switch 614 is in the second position 617; and the processor 622 may use the program instructions associated with the end actuator linkage upon detection through the sensors 630, for example, that the switch 614 is in the third or fourth position 618a, 618b.

[0236] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described herein, in accordance with an aspect of this description. The robotic surgical instrument 700 can be programmed or configured to control the distal/proximal translation of a displacing limb, the distal/proximal displacement of a closure tube, the rotation of the drive shaft, and articulation, either with a single type or multiple articulation drive links. In one aspect, the surgical instrument 700 may be programmed or configured to individually control a firing member, a closing member, a drive shaft member, or one or more pivot members, or combinations thereof. Surgical instrument 700 comprises a control circuit 710 configured to control motor-driven firing members, closing members, drive shaft members, or one or more pivot members, or combinations thereof.

[0237] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control a gripping arm 716 and a closing member 714, a portion of an end actuator 702, an ultrasonic blade 718 coupled to a transducer ultrasonic 719 excited by an ultrasonic generator 721, a drive shaft 740, and one or more pivot members 742a, 742b through a plurality of motors 704a to 704e. A position sensor 734 may be configured to provide feedback about the position of the closure member 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. A timer/counter 731 provides timing information and count to the control circuit 710. A power source 712 may be provided to operate the motors 704a to 704e and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a to 704e may be operated individually by the control circuit 710 in an open-loop or closed-loop feedback control.

[0238] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors, or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer/counter 731 provides an output signal, such as elapsed time or a digital count, to the control circuit 710 to correlate the position of the closure member 714 as determined by the position sensor 734 with the output of the timer. /counter 731 so that the control circuit 710 can determine the position of the closing member 714 at a specific time (t) relative to a starting position or the time (t) when the closing member 714 is in a specific position relative to an initial position. The 731 timer/counter can be configured to measure elapsed time, count external events, or measure external events.

[0239] In one aspect, the control circuit 710 may be programmed to control functions of the end actuator 702 based on one or more tissue conditions. The control circuit 710 may be programmed to directly or indirectly sense tissue conditions, such as thickness, as described herein. Control circuit 710 may be programmed to select a firing control program or closing control program based on fabric conditions. A trigger control program can describe the distal movement of the displacement limb. Different trigger control programs can be selected to best address different tissue conditions. For example, when thicker tissue is present, control circuit 710 can be programmed to translate the displacement member at a lower speed and/or with lower power. When thinner tissue is present, control circuit 710 can be programmed to translate the displacement member at a higher speed and/or with higher power. A closing control program can control the closing force applied to the fabric by the clamping arm 716. Other control programs control the rotation of the drive shaft 740 and the pivot members 742a, 742b.

[0240] In one aspect, the motor control circuit 710 can generate motor setpoint signals. Motor setpoint signals can be provided to multiple 708a through 708e motor controllers. The motor controllers 708a to 708e may comprise one or more circuits configured to provide motor drive signals to the motors 704a to 704e to drive the motors 704a to 704e as described herein. In some examples, motors 704a to 704e may be brushed direct current electric motors. For example, the speed of motors 704a to 704e may be proportional to respective motor drive signals. In some examples, motors 704a to 704e may be brushless DC electric motors, and respective motor drive signals may comprise a PWM signal provided to one or more stator windings of motors 704a to 704e. Furthermore, in some examples, the motor controllers 708a to 708e may be omitted and the control circuit 710 may directly generate the motor drive signals.

[0241] In one aspect, control circuit 710 may initially operate each of motors 704a to 704e in an open-loop configuration for a first open-loop portion of a stroke of the travel member. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, the control circuit 710 may select a trigger control program in a closed-loop configuration. The instrument response may include a translation of the distance from the traveling member during the open circuit portion, an elapsed time during the open circuit portion, the power supplied to one of the motors 704a to 704e during the open circuit portion, a sum of pulse widths of a motor drive signal, etc. After the open circuit portion, control circuit 710 may implement the selected firing control program for a second portion of travel of the travel member. For example, during a portion of the closed-loop stroke, the control circuit 710 may modulate one of the motors 704a to 704e based on translating data describing a position of the closed-loop travel member to translate the travel member to a constant speed.

[0242] In one aspect, motors 704a to 704e may receive power from a power source 712. The power source 712 may be a DC power source driven by an alternating main current power source, a battery, a super capacitor, or any other suitable power source. Motors 704a to 704e may be mechanically coupled to individual movable mechanical elements such as the closure member 714, the clamping arm 716, drive shaft 740, linkage 742a, and the linkage 742b, through respective transmissions 706a to 706e. Transmissions 706a to 706e may include one or more gears or other linkage components for coupling motors 704a to 704e to movable mechanical elements. A position sensor 734 may detect a position of the closure member 714. The position sensor 734 may be or may include any type of sensor that is capable of generating position data that indicates a position of the closure member 714. In some examples , the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 as the closure member 714 translates distally and proximally. The control circuit 710 may track the pulses to determine the position of the closure member 714. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals that indicate movement of the closure member 714. Additionally, in some examples, the position sensor 734 may be omitted. When any of the motors 704a to 704e is a stepper motor, the control circuit 710 can track the position of the closure member 714 by aggregating the number and direction of steps that the motor 704 has been instructed to perform. The position sensor 734 may be located in the end actuator 702 or in any other portion of the instrument. The outputs of each of the motors 704a to 704e include a torque sensor 744a to 744e for detecting force and have an encoder for detecting the rotation of the drive shaft.

[0243] In one aspect, the control circuit 710 is configured to actuate a firing member such as the closure member portion 714 of the end actuator 702. The control circuit 710 provides a motor set point for a control of the motor 708a, which provides a drive signal to the motor 704a. The motor output drive shaft 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a which is coupled to the closure member 714. The transmission 706a comprises movable mechanical elements such as rotating elements and a firing member for distally and proximally controlling the movement of the closure member 714 along a longitudinal axis of the end actuator 702. In one aspect, the motor 704a may be coupled to the knife gear assembly, which includes a knife gear reduction assembly, which includes a first knife drive gear and a second gear. knife drive. A torque sensor 744a provides a trigger force feedback signal to the control circuit 710. The trigger force signal represents the force required to trigger or displace the closure member 714. A position sensor 734 can be configured to provide the position of the closure member 714 along the firing stroke or the position of the firing member as a feedback signal to the control circuit 710. The end actuator 702 may include additional sensors 738 configured to provide feedback signals to the control circuit 710. When ready for use, the control circuit 710 can provide a trigger signal to the motor control 708a. In response to the trigger signal, the motor 704a may drive the firing member distally along the longitudinal axis of the end actuator 702 from a stroke start proximal position to a stroke end distal position relative to the stroke start position. course. As the closing member 714 translates distally, the clamping arm 716 closes toward the ultrasonic blade 718.

[0244] In one aspect, the control circuit 710 is configured to actuate a closure member such as the clamping arm portion 716 of the end actuator 702. The control circuit 710 provides a motor set point for a control of the motor 708b, which provides a drive signal to the motor 704b. The motor output drive shaft 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b which is coupled to the clamping arm 716. The transmission 706b comprises movable mechanical elements such as rotating elements and a closing member for controlling the movement of the clamping arm 716 from the open and closed. In one aspect, the motor 704b is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in mesh engagement with the closing gear wheel. Torque sensor 744b provides a closing force feedback signal to control circuit 710. The closing force feedback signal represents the closing force applied to clamping arm 716. Position sensor 734 can be configured to provide the position of the closing member as a feedback signal to the control circuit 710. Additional sensors 738 in the end actuator 702 can provide the closing force feedback signal to the control circuit 710. The pivotable clamping arm 716 is positioned opposite the ultrasonic blade 718. When ready for use, the control circuit 710 can provide a close signal to the motor control 708b. In response to the closing signal, the motor 704b advances a closing member to clamp the tissue between the clamping arm 716 and the ultrasonic blade 718.

[0245] In one aspect, the control circuit 710 is configured to rotate a drive shaft member, such as the drive shaft 740, to rotate the end actuator 702. The control circuit 710 provides a motor set point to a motor control 708c, which provides a drive signal to the motor 704c. The output drive shaft of the 704c engine is coupled to a 744c torque sensor. The torque sensor 744c is coupled to a transmission 706c which is coupled to the shaft 740. The transmission 706c comprises movable mechanical elements, such as rotating elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise until and above 360°. In one aspect, the motor 704c is coupled to the rotary drive assembly, which includes a tube gear segment that is formed over (or attached to) the proximal end of the proximal closure tube for engagement operable by a rotational gear assembly that is operationally supported on the tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the drive shaft 740. The position sensor 734 can be configured to provide the position of the closure member as a feedback signal to the control circuit 710. Additional sensors 738, such as a drive shaft encoder, may provide the rotational position of the drive shaft 740 to the control circuit 710.

[0246] In one aspect, the control circuit 710 is configured to articulate the end actuator 702. The control circuit 710 provides a motor set point for a motor control 708d, which provides a drive signal to the motor 704d. The 704d engine output drive shaft is coupled to a 744d torque sensor. Torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The transmission 706d comprises movable mechanical elements, such as linkage elements, to control the articulation of the end actuator 702 ± 65°. In one aspect, the motor 704d is coupled to a pivot nut, which is pivotally seated on the proximal end portion of the distal column portion and is pivotably driven therein by a pivot gear assembly. The torque sensor 744d provides a linkage force feedback signal to the control circuit 710. The linkage force feedback signal represents the linkage force applied to the end actuator 702. The sensors 738, such as a linkage encoder , may provide the pivot position of the end actuator 702 to the control circuit 710.

[0247] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or links, 742a, 742b. These articulation members 742a, 742b are driven by separate discs at the robot interface (the rack) which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each pivot link 742a, 742b may be antagonistically driven with respect to the other link to provide a resistive holding movement and a load to the head when it is not moving and to provide a holding movement. articulation when the head is articulated. Pivot members 742a, 742b attach to the head at a fixed radius when the head is rotated. Consequently, the mechanical advantage of the push-pull link changes when the head is rotated. This change in mechanical advantage may be more pronounced with other linkage drive systems.

[0248] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical connections to a firing member, closure member, or pivot member. Another example includes electric motors 704a to 704e that operate movable mechanical elements such as the displacement member, pivot links, shut-off tube and drive shaft. An external influence is an unmeasured and unpredictable influence of things such as tissue, surrounding bodies, and friction in the physical system. This external influence may be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influence, such as drag, can cause the operation of the physical system to deviate from a desired operation of the physical system.

[0249] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the position sensor 734 may comprise an absolute rotary magnetic positioning system implemented as a single integrated circuit rotary magnetic position sensor, AS5055EQFT, available from Austria Microsystems, AG, Austria. The position sensor 734 may interface with the control circuit 710 to provide an absolute positioning system. The position may include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which require only addition, subtraction, bit shift, and lookup table operations.

[0250] In one aspect, the control circuit 710 may be in communication with one or more sensors 738. The sensors 738 may be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure various derived parameters. such as span distance in relation to time, tissue compression in relation to time, and anvil deformation in relation to time. The sensors 738 may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other sensor suitable for measuring one or more parameters of the end actuator 702. The sensors 738 may include one or more sensors. Sensors 738 may be located on clamping arm 716 to determine tissue location using segmented electrodes. Torque sensors 744a to 744e can be configured to detect forces such as trigger force, closing force, and/or pivot force, among others. Accordingly, the control circuit 710 can detect (1) the closing load experienced by the distal closing tube and its position, (2) the firing member in the rack and its position, (3) which portion of the ultrasonic blade 718 has tissue in it, and (4) the load and position on both pivot rods.

[0251] In one aspect, the one or more sensors 738 may comprise a strain gauge, such as a microstrain gauge, configured to measure the magnitude of strain on anvil 716 during a pinched condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The sensors 738 may comprise a pressure sensor configured to detect a pressure generated by the presence of tissue compressed between the gripping arm 716 and the ultrasonic blade 718. The sensors 738 may be configured to detect the impedance of a section of tissue situated between the clamping arm 716 and the ultrasonic blade 718 which is indicative of the thickness and/or completeness of the tissue located between them.

[0252] In one aspect, sensors 738 may be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magneto-resistive (MR) devices, giant magneto-resistive (GMR) devices, magnetometers, among others. In other implementations, sensors 738 can be implemented as solid-state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. Furthermore, the switches can be solid-state devices such as transistors (e.g., FET, junction FET, MOSFET, bipolar, and the like). In other implementations, sensors 738 may include conductorless electrical switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

[0253] In one aspect, sensors 738 may be configured to measure the forces exerted on the clamping arm 716 by the closing drive system. For example, one or more sensors 738 may be at a point of interaction between the closure tube and the gripper arm 716 to detect the closure forces applied by the closure tube to the clamping arm 716. The forces exerted on the clamping arm 716. clamping 716 may be representative of the tissue compression experienced by the section of tissue captured between the clamping arm 716 and the ultrasonic blade 718. The one or more sensors 738 may be positioned at various interaction points along the closure drive system to detect the closing forces applied to the clamping arm 716 by the closing drive system. The one or more sensors 738 may be sampled in real-time during a grasping operation by the control circuit processor 710. The control circuit 710 receives real-time sample measurements to provide and analyze time-based information and evaluate timely real, the closing forces applied to the clamping arm 716.

[0254] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the motors 704a to 704e. The force required to advance any of the movable mechanical elements such as the closure member 714 corresponds to the current drawn by one of the motors 704a to 704e. The force is converted to a digital signal and supplied to the control circuit 710. The control circuit 710 can be configured to simulate the response of the actual instrument system in the controller software. A displacement member may be actuated to move the closure member 714 in the end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID, state feedback, linear quadratic (LQR) controller, and/or an adaptive controller. , for example. The robotic surgical instrument 700 may include a power source for converting the feedback controller signal into a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque, and/or force, for example. Additional details are described in US Patent Application Serial No. 15/636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed June 29, 2017, which is incorporated herein by reference in its entirety.

[0255] Figure 18 illustrates a schematic diagram of a surgical instrument 750 configured to control distal translation of the displacement member in accordance with an aspect of the present description. In one aspect, the surgical instrument 750 is programmed to control the distal translation of the displacement member as the closing member 764. The surgical instrument 750 comprises an end actuator 752 which may comprise a clamping arm 766, a closing member 764 and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0256] The position, movement, displacement, and/or translation of a linear displacement member, such as closure member 764, may be measured by an absolute positioning system, sensor arrangement, and a position sensor 784. Because the closure member 764 is coupled to a longitudinally movable drive member, the position of the closure member 764 can be determined by measuring the position of the longitudinally movable drive member employing the position sensor 784. Accordingly, in the following description , the position, displacement and/or translation of the closure member 764 can be obtained by the position sensor 784, as described in the present invention. A control circuit 760 may be programmed to control the translation of the displacement member, such as the closure member 764. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors, or other processors suitable for executing instructions. which cause the processor or processors to control the displacement member, e.g., the closing member 764, in the manner described. In one aspect, a timer/counter 781 provides an output signal, such as elapsed time or a digital count, to the control circuit 760 to correlate the position of the closure member 764 as determined by the position sensor 784 with the output of the timer. /counter 781 so that the control circuit 760 can determine the position of the closure member 764 at a specific time (t) relative to an initial position. The 781 timer/counter can be configured to measure elapsed time, count external events, or measure external events.

[0257] The control circuit 760 may generate a motor setpoint signal 772. The motor setpoint signal 772 may be provided to a motor controller 758. The motor controller 758 may comprise one or more circuits configured to provide a drive signal from engine 774 to engine 754 to drive engine 754 as described herein. In some examples, the motor 754 may be a DC motor with a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor and the motor drive signal 774 may comprise a PWM signal supplied to a or more stator windings of the motor 754. Furthermore, in some examples, the motor controller 758 may be omitted, and the control circuit 760 may generate the motor drive signal 774 directly.

[0258] The motor 754 may receive power from a power source 762. The power source 762 may be or include a battery, a super capacitor, or any other suitable power source. The motor 754 may be mechanically coupled to the closure member 764 via a transmission 756. The transmission 756 may include one or more gears or other linkage components for coupling the motor 754 to the closure member 764. A position sensor 784 may detect a position of the closure member 764. The position sensor 784 may be or may include any type of sensor that is capable of generating position data that indicates a position of the closure member 764. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 as the closure member 764 translates distally and proximally. The control circuit 760 may track the pulses to determine the position of the closure member 764. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals that indicate movement of the closure member 764. Additionally, in some examples, the position sensor 784 may be omitted. When the motor 754 is a stepper motor, the control circuit 760 can track the position of the closure member 764 by aggregating the number and orientation of steps that the motor 754 has been instructed to perform. The position sensor 784 may be located in the end actuator 752 or in any other portion of the instrument.

[0259] The control circuit 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure various derived parameters, such as span distance. as a function of time, tissue compression as a function of time and anvil tension as a function of time. The sensors 788 may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, a optical and/or any other sensors suitable for measuring one or more parameters of the end actuator 752. The sensors 788 may include one or more sensors.

[0260] The one or more sensors 788 may comprise a strain gauge, such as a microstress gauge, configured to measure the magnitude of strain on anvil 766 during a tight condition. The voltage meter provides an electrical signal whose amplitude varies with the magnitude of the voltage. The sensors 788 may comprise a pressure sensor configured to detect a pressure generated by the presence of tissue compressed between the gripping arm 766 and the ultrasonic blade 768. The sensors 788 may be configured to detect the impedance of a section of tissue situated between the clamping arm 766 and the ultrasonic blade 768 which is indicative of the thickness and/or completeness of the tissue located between them.

[0261] Sensors 788 can be configured to measure the forces exerted on the clamping arm 766 by the closing drive system. For example, one or more sensors 788 may be at a point of interaction between the clamping tube and the gripper arm 766 to detect closing forces applied by a clamping tube to the clamping arm 766. The forces exerted on the clamping arm 766. The clamping arm 766 may be representative of the tissue compression experienced by the section of tissue captured between the clamping arm 766 and the ultrasonic blade 768. The one or more sensors 788 may be positioned at various interaction points along the closure drive system. to detect the closing forces applied to the clamping arm 766 by the closing drive system. The one or more sensors 788 may be sampled in real time during a grasping operation by a processor of the control circuit 760. The control circuit 760 receives real-time sample measurements to provide and analyze time-based information and evaluate, in in real time, the closing forces applied to the clamping arm 766.

[0262] A current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the closure member 764 corresponds to the current drawn by the motor 754. The force is converted into a digital signal and supplied to the circuit control 760.

[0263] The control circuit 760 can be configured to similar to the response of the actual instrument system in the controller software. A displacement member may be actuated to move a closure member 764 in the end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, status feedback, LQR, and/or an adaptive controller, for example. The surgical instrument 750 may include a power source to convert the feedback controller signal into a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque, and/or force, for example.

[0264] The actual drive system of the surgical instrument 750 is configured to drive the traveling member, the cutting member, or the closing member 764, by a brushed DC motor with gearbox and mechanical linkages to a linkage system and /or knife. Another example is the electric motor 754 that operates the travel member and the pivot driver, for example, of an interchangeable drive shaft assembly. An external influence is an unmeasured and unpredictable influence of things such as tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, such as drag, can cause the operation of the physical system to deviate from a desired operation of the physical system.

[0265] Various exemplary aspects are directed to a surgical instrument 750 comprising an end actuator 752 with motor-driven sealing and cutting surgical implements. For example, a motor 754 may drive a displacement member distally and proximally along a longitudinal axis of the end actuator 752. The end actuator 752 may comprise a pivotable clamping arm 766 and, when configured for use, a ultrasonic blade 768 positioned on the opposite side of the clamping arm 766. A clinician can hold tissue between the clamping arm 766 and the ultrasonic blade 768 as described in the present invention. When ready to use the instrument 750, the practitioner may provide a trigger signal, for example, by pressing a trigger of the instrument 750. In response to the trigger signal, the motor 754 may drive the displacement member distally along the longitudinal axis. of the end actuator 752 from a proximal start-of-stroke position to an end-of-stroke position distal to the start-of-stroke position. As the travel member moves distally, the closing member 764 with a cut positioned at a distal end, can cut the tissue between the ultrasonic blade 768 and the clamping arm 766.

[0266] In various examples, the surgical instrument 750 may comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the closing member 764, for example, based on one or more tissue conditions. The control circuit 760 may be programmed to directly or indirectly sense tissue conditions, such as thickness, as described herein. Control circuit 760 may be programmed to select a control program based on tissue conditions. A control program can describe the distal movement of the displacement limb. Different control programs can be selected to best treat different tissue conditions. For example, when thicker tissue is present, control circuit 760 may be programmed to translate the travel member at a lower speed and/or with lower power. When thinner tissue is present, control circuit 760 can be programmed to translate the displacement member at a higher speed and/or with higher power.

[0267] In some examples, control circuit 760 may initially operate motor 754 in an open-loop configuration for a first open-loop portion of a stroke of the travel member. Based on a response from instrument 750 during the open circuit portion of the stroke, control circuit 760 may select a firing control program. The instrument response may include a translational distance of the travel member during the open-circuit portion, an elapsed time during the open-circuit portion, the power supplied to motor 754 during the open-circuit portion, a sum of pulse widths of a motor drive signal, etc. After the open circuit portion, control circuit 760 may implement the selected firing control program for a second portion of travel of the travel member. For example, during the closed-loop portion of the stroke, control circuit 760 may modulate motor 754 based on translational data describing a position of the travel member in a closed-loop manner to translate the travel member in a constant speed. Additional details are described in US Patent Application Serial No. 15/720,852, entitled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, filed on September 29, 2017, which is incorporated herein by reference in its entirety.

[0268] Figure 19 is a schematic diagram of a surgical instrument 790 configured to control various functions, in accordance with an aspect of the present description. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member such as the closing member 764. The surgical instrument 790 comprises an end actuator 792 which may comprise a gripping arm 766, a closing member 764, and an ultrasonic blade 768 that can be interchanged with or function in conjunction with one or more RF electrodes 796 (shown in dashed line). The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

[0269] In one aspect, sensors 788 can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MR devices, GMR devices, magnetometers, among others. In other implementations, sensors 638 may be solid-state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. Furthermore, the switches can be solid-state devices such as transistors (e.g., FET, junction FET, MOSFET, bipolar, and the like). In other implementations, sensors 788 may include conductorless electrical switches, ultrasonic switches, accelerometers, inertial sensors, and so on.

[0270] In one aspect, the position sensor 784 can be implemented as an absolute positioning system, which comprises a rotary magnetic absolute positioning system implemented as a single integrated circuit rotary magnetic position sensor, AS5055EQFT, available from Austria Microsystems, AG, Austria. The position sensor 784 may interface with the control circuit 760 to provide an absolute positioning system. The position may include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit method and Volder's algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which require only addition, subtraction, bit shift, and lookup table operations.

[0271] In some examples, position sensor 784 may be omitted. When the motor 754 is a stepper motor, the control circuit 760 can track the position of the closure member 764 by aggregating the number and orientation of the steps that the motor has been instructed to perform. The position sensor 784 may be located in the end actuator 792 or in any other portion of the instrument.

[0272] The control circuit 760 may be in communication with one or more sensors 788. The sensors 788 may be positioned on the end actuator 792 and adapted to work with the surgical instrument 790 to measure various derived parameters, such as span distance. as a function of time, tissue compression as a function of time and anvil tension as a function of time. The sensors 788 may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, a optical and/or any other sensors suitable for measuring one or more parameters of the end actuator 792. The sensors 788 may include one or more sensors.

[0273] An RF energy source 794 is coupled to the end actuator 792 and is applied to the RF electrode 796 when the RF electrode 796 is provided in the end actuator 792 in place of the ultrasonic blade 768 or to work in conjunction with the 768 ultrasonic blade. For example, the ultrasonic blade is produced from electrically conductive metal and can be used as the return path for RF electrosurgical current. Control circuit 760 controls the delivery of RF energy to RF electrode 796.

[0274] Additional details are described in US Patent Application Serial No. 15/636,096, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed June 28, 2017, which is incorporated herein for reference in its entirety.

Adaptive ultrasonic blade control algorithms

[0275] In various aspects, intelligent ultrasonic power devices may comprise adaptive algorithms to control the operation of the ultrasonic blade. In one aspect, adaptive ultrasonic blade control algorithms are configured to identify tissue type and adjust device parameters. In one aspect, the ultrasonic blade control algorithms are configured to parameterize the tissue type. An algorithm for detecting the collagen/tissue ratio to adjust the amplitude of the distal tip of the ultrasonic blade is described in the following section of the present description. Various aspects of smart ultrasonic devices are described herein in connection with Figures 1 to 94, for example. Accordingly, the following description of the adaptive ultrasonic blade control algorithms should be read in conjunction with Figures 1 through 94 and the description associated therewith.

Identification of tissue type and device parameter adjustments

[0276] In certain surgical procedures it would be desirable to use adaptive ultrasonic blade control algorithms. In one aspect, adaptive ultrasonic blade control algorithms can be used to adjust the parameters of the ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, the parameters of the ultrasonic device can be adjusted based on the location of the tissue within the jaws of the ultrasonic end actuator, e.g., the location of the tissue between the gripping arm and the ultrasonic blade. The impedance of the ultrasonic transducer can be used to differentiate the percentage of tissue that is situated at the distal or proximal end of the tip actuator. Ultrasonic device reactions can be based on tissue type or tissue compressibility. In another aspect, the parameters of the ultrasonic device can be adjusted based on the identified tissue type or parameterization. For example, the amplitude of the mechanical displacement of the distal tip of the ultrasonic blade can be adjusted based on the ratio of collagen to elastin in the tissue detected during the tissue identification procedure. The ratio of tissue collagen to elastin can be detected using a variety of techniques including reflectance and surface emissivity in infrared (IR) reflectance. The force applied to the fabric by the clamping arm and/or the travel of the clamping arm to produce gap and compression. Electrical continuity across a gripper equipped with electrodes can be used to determine the percentage of the gripper that is covered with tissue.

[0277] Figure 20 is a system 800 configured to execute adaptive ultrasonic blade control algorithms on a surgical data network comprising a modular communication hub, in accordance with at least one aspect of the present description. In one aspect, the generator module 240 is configured to execute the adaptive ultrasonic blade control algorithm(s) 802, as described herein with reference to Figures 53 to 94. In another aspect, the device/ instrument 235 is configured to execute the control algorithm(s) of the adaptive ultrasonic blade(s) 804, as described herein with reference to Figures 53 to 59. In another aspect, both the device/instrument 235 and the device /instrument 235 are configured to execute the adaptive ultrasonic blade control algorithms 802, 804 as described herein with reference to Figures 53 to 94.

[0278] Generator module 240 may comprise an isolated patient stage communicating with a non-isolated stage via a power transformer. A secondary winding of the power transformer is contained in the isolated stage and may comprise a tapped configuration (e.g., a center-tapped or non-center-tapped configuration) to define drive signal outputs to deliver drive signals. to different surgical instruments, such as an ultrasonic surgical device and an RF electrosurgical instrument, and a multifunctional surgical instrument that includes ultrasonic and RF energy modes that can be delivered alone or simultaneously. In particular, the drive signal outputs may output an ultrasonic drive signal (e.g., a 420 V root mean square (RMS) drive signal for an ultrasonic surgical instrument 241, and the drive signal outputs may output 21 to 28B.

[0279] The generator module 240 or the device/instrument 235 or both are coupled to the modular control tower 236 connected to multiple operating room devices such as intelligent surgical instruments, robots, and other computerized devices located in the operating room. operation, as described with reference to Figures 8 to 11, for example.

[0280] Figure 21 illustrates an example of a generator 900, which is one form of a generator configured to couple to an ultrasonic instrument and further configured to execute adaptive ultrasonic blade control algorithms in a surgical data network comprising a hub of modular communication as shown in Figure 20. Generator 900 is configured to provide multiple modalities of power to a surgical instrument. Generator 900 provides ultrasonic and RF signals to power a surgical instrument, independently or simultaneously. Ultrasonic and RF signals can be provided alone or in combination and can be provided simultaneously. As indicated above, at least one generator output can provide multiple modalities of energy (e.g., ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others) through a single port, and these signals can be provided separately or simultaneously to the end actuator to treat tissue. The generator 900 comprises a processor 902 coupled to a waveform generator 904. The processor 902 and the waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory coupled to the processor 902 , not shown for clarity of description. Digital information associated with a waveform is provided to waveform generator 904 including one or more A-D converter circuits (analog-to-digital converters) to convert the digital input to an analog output. The analog output is fed to a 1106 amplifier for signal conditioning and amplification. The conditioned and amplified output of amplifier 906 is coupled to a power transformer 908. Signals are coupled by power transformer 908 to the secondary side, which is on the patient isolation side. A first signal of a first power modality is supplied to the surgical instrument between the terminals labeled POWER1 and RETURN. A second signal of a second energy modality is coupled by a capacitor 910 and is supplied to the surgical instrument between the terminals labeled POWER2 and RETURN. It will be recognized that more than two modes of energy may be emitted and therefore the subscript "n" may be used to designate that up to n terminals of ENERGY may be provided, where n is a positive integer greater than 1. It will also be It is recognized that up to "n" return trajectories, RETURNn may be provided without departing from the scope of the present description.

[0281] A first voltage detection circuit 912 is coupled across the terminals labeled POWER1 and the RETURN path to measure the output voltage between them. A second voltage detection circuit 924 is coupled across the terminals labeled POWER2 and the RETURN path to measure the output voltage between them. A current sensing circuit 914 is arranged in series with the RETURN leg of the secondary side of the power transformer 908 as shown to measure the output current for any power modality. If different return paths are provided for each power modality, then a separate current sensing circuit would be provided on each return leg. The outputs of the first and second voltage sensing circuits 912, 924 are supplied to respective isolation transformers 916, 922 and the output of the current sensing circuit 914 is supplied to another isolation transformer 918. isolation 916, 928, 922 on the primary side of the power transformer 908 (non-isolated patient side) are provided to one or more ADC circuits 926. The digitized output of the A-D converter circuit 926 is provided to the processor 902 for further processing and computation . The output voltages and output current feedback information can be employed to adjust the output voltage and current supplied to the surgical instrument, and to compute the output impedance, among other parameters. Input/output communications between the processor 902 and the patient's isolated circuits are provided through an interface circuit 920. The sensors may also be in electrical communication with the processor 902 through the interface circuit 920.

[0282] In one aspect, the impedance may be determined by the processor 902 by dividing the output of the first voltage sensing circuit 912 coupled over the terminals labeled POWER1/RETURN or the second voltage sensing circuit 924 coupled over the terminals identified as POWER2/RETURN, by the output of the current sensing circuit 914 disposed in series with the RETURN leg of the secondary side of the power transformer 908. The outputs of the first and second voltage sensing circuits 912, 924 are provided to separate the isolation transformers 916, 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 916. Digitized voltage and current sensing measurements from the A-D converter circuit 926 are provided to the processor 902 to compute the impedance. As an example, the first energy modality ENERGY1 may be ultrasonic energy and the second energy modality ENERGY2 may be RF energy. However, in addition to ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. Furthermore, although the example illustrated in Figure 21 shows a single RETURN return trajectory that may be provided for two or more energy modalities, in other aspects, multiple RETURN return trajectories may be provided for each energy modality ENERGIAn. Thus, as described herein, the impedance of the ultrasonic transducer can be measured by dividing the output of the first voltage sensing circuit 912 by the current sensing circuit 914 and the tissue impedance can be measured by dividing the output of the second voltage sensing circuit 924 by current sensing circuit 914.

[0283] As shown in Figure 21, the generator 900 comprising at least one output port may include a power transformer 908 with a single output and with multiple taps for providing power in the form of one or more energy modalities, such as ultrasonic , bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others, for example, to the tip actuator depending on the type of tissue treatment being performed. For example, generator 900 may provide power at higher voltage and lower current to drive an ultrasonic transducer, at lower voltage and higher current to drive RF electrodes to seal tissue, or with a coagulation waveform for spot coagulation using electrosurgical electrodes. Monopolar or bipolar RF. The output waveform of the generator 900 may be steered, switched, or filtered to provide the frequency to the end actuator of the surgical instrument. The connection of an ultrasonic transducer to the output of the generator 900 would preferably be located between the output labeled POWER1 and RETURN, as shown in Figure 21. In one example, a connection of bipolar RF electrodes to the output of the generator 900 would preferably be located between the output identified as ENERGY2 and the RETURN. In the case of a monopolar output, the preferred connections would be active electrode (e.g. light beam or other probe) to the POWER2 output and a suitable return block connected to the RETURN output.

[0284] Additional details are described in US Patent Application Publication No. 2017/0086914 entitled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, which was published on March 30, 2017, which is incorporated herein by title reference in its entirety.

[0285] As used throughout this description, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc., that can communicate data through the use of electromagnetic radiation modulated through a non-solid medium. The term does not imply that the associated devices do not contain any wires, although in some respects they may not. The communication module may implement any of a number of wireless and wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, evolution (LTE, "long-term evolution"), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other protocols without wired and wired which are designated as 3G, 4G, 5G, and beyond. The computing module may include a plurality of communication modules. For example, a first communication module may be dedicated to short-range wireless communications such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to longer-range wireless communications such as GPS, EDGE, GPRS, CDMA , WiMAX, LTE, Ev-DO, and others.

[0286] As used in the present invention a processor or processing unit is an electronic circuit that performs operations on some external data source, generally memory or some other data stream. The term is used in the present invention to refer to the central processor (central processing unit) in a computer system or systems (specifically systems on a chip (SoCs)) that combine several specialized "processors".

[0287] As used herein, a system on a chip or system on chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all of the components of a computer or other electronic systems . It can contain digital, analog, mixed and often radio frequency functions — all on a single substrate. An SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), i-Fi module, or coprocessor. An SoC may or may not contain internal memory.

[0288] As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to an SoC; an SoC may include a microcontroller as one of its components. A microcontroller may contain one or more core processing units (CPUs) along with memory and programmable input/output peripherals. Program memory in the form of ferroelectric RAM, NOR flash, or OTP ROM is also often included on the chip, as well as a small amount of RAM. Microcontrollers can be used for integrated applications, in contrast to microprocessors used in personal computers or other general-purpose applications that consist of several discrete integrated circuits.

[0289] As used in the present invention, the term controller or microcontroller can be an independent chip or IC (integrated circuit) device that interfaces with a peripheral device. This may be a link between two parts of a computer or a controller on an external device that manages the operation of (and connection to) that device.

[0290] Any of the processors or microcontrollers in the present invention can be any implemented by any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one aspect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz. , a look-ahead buffer to optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, 2 KB electrically erasable programmable readout (EEPROM), one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder inputs (QEI), one or more analog to digital converters (ADC) 12-bit with 12 analogue input channels, details of which are available in the product datasheet.

[0291] In one aspect, the processor may comprise a security controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety-critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity, and memory options.

[0292] Modular devices include modules (as described in connection with Figures 3 and 9, for example) that are receivable within a surgical hub and surgical devices or instruments that can be connected to the various modules in order to connect or pair with the corresponding surgical hub. Modular devices include, for example, smart surgical instruments, medical imaging devices, suction/irrigation devices, smoke evacuators, power generators, ventilators, insufflators, and displays. The modular devices described here can be controlled by control algorithms. The control algorithms may be executed on the modular device itself, on the surgical hub to which the specific modular device is paired, or on both the modular device and the surgical hub (e.g., surgical hub) via a distributed computing architecture ). In some examples, the modular device control algorithms control the devices based on data detected by the modular device itself (i.e., by sensors in, on, or connected to the modular device. This data can be related to the patient being operated on). (e.g., tissue properties or inflation pressure) or to the modular device itself (e.g., the rate at which a knife is being advanced, the motor current, or the energy levels. For example, an algorithm). control for a surgical stapling and cutting instrument can control the rate at which the instrument's motor drives its knife through tissue according to the resistance encountered by the knife as it advances.

[0293] Figure 22 illustrates one form of a surgical system 1000 comprising a generator 1100 and various surgical instruments 1104, 1106 and 1108 usable therewith, wherein the surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument 1106 is an RF electrosurgical instrument, and the 1108 multifunctional surgical instrument is a combination ultrasonic/RF electrosurgical instrument. The 1100 generator is configurable for use with a variety of surgical instruments. In various ways, the generator 1100 may be configurable for use with different surgical instruments of different types, including, for example, the ultrasonic surgical instrument 1104, the RF electrosurgical instruments 1106, and the multifunctional surgical instrument 1108 that integrates ultrasonic and 22 the generator 1100 is shown separately from the surgical instruments 1104, 1106, 1108 in one form, the generator 1100 may be formed integrally with any of the surgical instruments 1104, 1106 and 1108 to form a unitary surgical system. The generator 1100 comprises an input device 1110 located on a front panel of the generator 1100 console. The input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may be configured to wired or wireless communication.

[0294] The generator 1100 is configured to drive multiple surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and comprises a handle 1105 (HP), an ultrasonic transducer 1120, a drive shaft 1126, and a end actuator 1122. The end actuator 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a grip arm 1140. The grip 1105 comprises a trigger 1143 for operating the grip arm 1140 and a combination of toggle buttons 1134a , 1134b, 1134c to energize and drive the ultrasonic blade 1128 or other function. Toggle buttons 1134a, 1134b, 1134c can be configured to energize the ultrasonic transducer 1120 with the generator 1100.

[0295] The generator 1100 is also configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and comprises a handle 1107 (HP), a drive shaft 1127, and an end actuator 1124. End actuator 1124 comprises electrodes on clamping arms 1142a and 1142b and return through the electrical conductor portion of the drive shaft 1127. The electrodes are coupled to and energized by the bipolar power source within the generator 1100. The handle 1107 comprises a trigger 1145 for operating the gripping arms 1142a, 1142b and a power button 1135 for actuating a power switch to energize the electrodes on the end actuator 1124.

[0296] The generator 1100 is also configured to drive a multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 comprises a handle 1109 (HP), a drive shaft 1129, and an end actuator 1125. The end actuator 1125 comprises a blade ultrasonic transducer 1149 and a clamping arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The handle 1109 comprises a trigger 1147 for operating the clamping arm 1146 and a combination of toggle buttons 1137a, 1137b, 1137c for energizing and activate the ultrasonic blade 1149 or another function. Toggle buttons 1137a, 1137b, 1137c can be configured to energize the ultrasonic transducer 1120 with the generator 1100 and energize the ultrasonic blade 1149 with the bipolar power source also contained within the generator 1100.

[0297] Generator 1100 is configurable for use with a variety of surgical instruments. In various ways, the generator 1100 may be configurable for use with different surgical instruments of different types, including, for example, the ultrasonic surgical instrument 1104, the RF surgical instrument 1106, and the multifunctional surgical instrument 1108 that integrates ultrasonic and 22 the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108 in another form, the generator 1100 may be formed integrally with any of the surgical instruments 1104, 1106, 1108 to form a unitary surgical system. As discussed above, the generator 1100 comprises an input device 1110 located on a front panel of the generator 1100 console. The input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may also comprise one or more output devices 1112. Other aspects of generators for digitally generating electrical signal waveforms and surgical instruments are described in patent publication US-2017-0086914-A1, which is incorporated herein by reference. reference in its entirety.

[0298] Figure 23 is an end actuator 1122 of the exemplary ultrasonic device 1104, in accordance with at least one aspect of the present description. The end actuator 1122 may comprise a blade 1128 that may be coupled to the ultrasonic transducer 1120 via a waveguide. When activated by the ultrasonic transducer 1120, the blade 1128 can vibrate and, when placed in contact with tissues, can cut and/or coagulate them, as described in the present invention. In various aspects, and as illustrated in Figure 23, the end actuator 1122 may also comprise a clamping arm 1140 that may be configured for cooperative action with the blade 1128 of the end actuator 1122. With the blade 1128, the arm gripper 1140 may comprise a set of claws. The clamping arm 1140 may be pivotally connected to a distal end of a drive shaft 1126 of the instrumental portion 1104. The clamping arm 1140 may include a block of clamping arm fabric 1163, which may be formed from Teflon. ® or other suitable low friction material. The block 1163 may be assembled for cooperation with the blade 1128, with pivoting movement of the clamping arm 1140 positioning the clamping block 1163 in a relationship substantially parallel to, and in contact with, the blade 1128. For this construction, a portion The tissue block 1163 may be clamped between the tissue block 1163 and the blade 1128. The tissue block 1163 may be provided with a sawtooth-like configuration including a plurality of axially spaced and proximally extending gripping teeth 1161. improve tissue grip in cooperation with the blade 1128. The clamping arm 1140 can transition from the open position shown in Figure 23 to a closed position (with the clamping arm 1140 in contact with or near the blade 1128) of any appropriate way. For example, the grip 1105 may comprise a claw closing trigger. When actuated by a clinician, the jaw closing trigger can rotate gripping arm 1140 in any suitable manner.

[0299] The generator 1100 may be activated to provide the drive signal to the ultrasonic transducer 1120 in any suitable manner. For example, the generator 1100 may comprise a foot switch 1430 (Figure 24) coupled to the generator 1100 via a foot switch cable 1432. A clinician may activate the ultrasonic transducer 1120 and thereby the ultrasonic transducer 1120 and the blade 1128 by pressing the foot switch 1430. In addition, or instead of the foot switch 1430, some aspects of the ultrasonic device 1104 may utilize one or more switches positioned on the handle 1105 which, when activated, may cause the generator to 1100 activates the ultrasonic transducer 1120. In one aspect, for example, the one or more switches may comprise a pair of toggle buttons 1134a, 1134b, 1134c (Figure 22), for example, to determine a mode of operation of the device 1104. When the toggle button 1134a is pressed, for example, the ultrasonic generator 1100 can provide a maximum drive signal to the transducer 1120, causing it to produce a maximum ultrasonic energy output. Pressing the toggle button 1134b may cause the ultrasonic generator 1100 to provide a user-selectable drive signal to the ultrasonic transducer 1120, causing it to produce less than the maximum ultrasonic power output. The device 1104 may additionally or alternatively comprise a second switch for, for example, indicating a position of a gripper closing trigger for operating the grippers via the clamping arm 1140 of the end actuator 1122. Furthermore, in some aspects, the ultrasonic generator 1100 may be activated based on the position of the clamp closing trigger, (e.g., as the clinician presses the clamp closing trigger to close through the gripping arm 1140, ultrasonic energy may be applied).

[0300] Additionally or alternatively, the one or more switches may comprise a toggle button 1134c which, when pressed, causes the generator 1100 to provide a pulsed output (Figure 22). Pulses can be delivered at any suitable frequency and grouping, e.g. In certain aspects, the power level of the pulses may consist of the power levels associated with toggle buttons 1134a, 1134b (maximum, less than maximum), for example.

[0301] It will be recognized that a device 1104 may comprise any combination of toggle buttons 1134a, 1134b, 1134c (Figure 22). For example, device 1104 could be configured to have only two toggle buttons: a toggle button 1134a to produce a maximum ultrasonic power output and a toggle button 1134c to produce a pulsed output, either at the power level maximum or less than maximum. Thus, the drive signal output configuration of the generator 1100 could be five continuous signals, or any discrete number of individual pulsed signals (1, 2, 3, 4 or 5). In certain aspects, the specific drive signal configuration may be controlled based on, for example, EEPROM settings in generator 1100 and/or user power level selections.

[0302] In certain aspects, a two-position switch may be offered as an alternative to a toggle button 1134c (Figure 22). For example, a device 1104 may include a toggle switch 1134a for producing a continuous output at a maximum power level and a two-position toggle switch 1134b. In a first predetermined position, the toggle button 1134b may produce a continuous output at a power level less than the maximum, and in a second detent position, the toggle button 1134b may produce a pulsed output (e.g., at a maximum or less than maximum power level, depending on the EEPROM configuration).

[0303] In some aspects, the RF electrosurgical end actuator 1124, 1125 (Figure 22) may also comprise a pair of electrodes. The electrodes may be in communication with the generator 1100, for example, via a cable. The electrodes can be used, for example, to measure an impedance of a tissue portion present between the clamping arm 1142a, 1146 and the blade 1142b, 1149. The generator 1100 can provide a signal (e.g., a non-therapeutic signal) to the electrodes. The impedance of the tissue portion can be found, for example, by monitoring current, voltage, etc. of the signal.

[0304] In various aspects, the generator 1100 may comprise several separate functional elements, such as modules and/or blocks, as shown in Figure 24, a diagram of the surgical system 1000 of Figure 22. Different modules or functional elements may be configured to drive different types of surgical devices 1104, 1106, 1108. For example, an ultrasonic generator module can drive an ultrasonic device, such as ultrasonic instrument 1104. An electrosurgery/RF generator module can drive the electrosurgical device 1106. The modules can generate respective drive signals for driving the surgical devices 1104, 1106, 1108. In various aspects, each of the ultrasonic generator module and/or the electrosurgery/RF generator module may be formed integrally with the generator 1100. Alternatively, one or more of the modules may be provided as a separate circuit module electrically coupled to the generator 1100. (The modules are shown in dashed line to illustrate this option.) Additionally, in some aspects the electrosurgery/RF generator module may be integrally formed with the ultrasonic generator, or vice versa.

[0305] According to the aspects described, the ultrasonic generator module can produce one or more drive signals with specific voltages, currents and frequencies (e.g., 55,500 cycles per second, or Hz). The one or more drive signals may be provided to the ultrasonic device 1104 and specifically to the transducer 1120, which may operate, for example, as described above. In one aspect, the generator 1100 can be configured to produce a drive signal of a specific voltage, current, and/or frequency output signal that can be performed with high resolution, accuracy, and repeatability.

[0306] According to the aspects described, the generator module for electrosurgery/RF can generate one or more drive signals with sufficient output power to perform bipolar electrosurgery using radiofrequency (RF) energy. In bipolar electrosurgery applications, the drive signal may be provided, for example, to the electrodes of the electrosurgical device 1106, for example, as described above. Accordingly, the generator 1100 can be configured for therapeutic purposes by applying electrical energy to the tissue sufficient to treat said tissue (e.g., coagulation, cauterization, tissue welding, etc.).

[0307] The generator 1100 may comprise an input device 2150 (Figure 27B) located, for example, on a front panel of the generator console 1100. The input device 2150 may comprise any suitable device that generates signals suitable for programming the operation of the generator 1100. In operation, the user may program or otherwise control the operation of the generator 1100 using the input device 2150. The input device 2150 may comprise any suitable device that generates signals that can be used by the generator (e.g., by one or more processors contained in the generator) to control the operation of the generator 1100 (e.g., the operation of the ultrasonic generator module and/or the electrosurgery/RF generator module). In various aspects, input device 2150 includes one or more of buttons, switches, rotary controls, keyboard, numeric keypad, touch screen monitor, pointing device, and remote connection to a general-purpose or dedicated computer. In other aspects, input device 2150 may comprise a suitable user interface, such as one or more user interface screens displayed on a touch screen monitor, for example. Consequently, through input device 2150, the user can adjust or program various operating parameters of the generator, such as current (I), voltage (V), frequency (f), and/or period (T) of one or more input signals. drives generated by the ultrasonic generator module and/or the electrosurgery/RF generator module.

[0308] The generator 1100 may comprise an output device 2140 (Figure 27B) situated, for example, on a front panel of the generator console 1100. The output device 2140 includes one or more devices for providing the user with sensory feedback. Such devices may comprise, for example, visual feedback devices (e.g., a monitor with an LCD screen, LED indicators), auditory feedback devices (e.g., a speaker, a buzzer) or tactile feedback devices (e.g., e.g. haptic actuators).

[0309] Although certain modules and/or blocks of generator 1100 may be described by way of example, it should be considered that a greater or lesser number of modules and/or blocks may be used and still be within the scope of the aspects. Furthermore, although various aspects may be described in terms of modules and/or blocks for ease of description, these modules and/or blocks may be implemented by one or more hardware components, e.g., processors, digital signal processors (DSPs) ), programmable logic devices (PLDs), application-specific integrated circuits (ASICs), circuits, registers, and/or software components, e.g., programs, subroutines, logic, and/or combinations of hardware and software components.

[0310] In one aspect, the ultrasonic generator drive module and the electrosurgery/RF drive module 1110 (Figure 22) may comprise one or more integrated applications, implemented as firmware, software, hardware, or any combination thereof. Modules can comprise various executable modules, such as software, programs, data, triggers, and application program interfaces (APIs), among others. The firmware may be stored in non-volatile memory (NVM), such as read-only memory (ROM) with a bit mask, or flash memory. In many implementations, storing firmware in ROM can preserve flash memory. The NVM may comprise other types of memory including, for example, programmable ROM (PROM), erasable programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM, programmable ROM"), or battery backed random-access memory (RAM, "random-access memory") such as dynamic RAM (DRAM, "dynamic RAM"), DRAM with double data rate (DDRAM, "Double -Data- Rate DRAM"), and/or synchronous DRAM (SDRAM, for "synchronous DRAM").

[0311] In one aspect, the modules comprise a hardware component implemented as a processor for executing program instructions for monitoring various measurable characteristics of devices 1104, 1106, 1108 and generating a corresponding output drive signal or signals for the operation of devices 1104, 1106, 1108. In aspects in which generator 1100 is used in conjunction with device 1104, the drive signal may drive ultrasonic transducer 1120 in cutting and/or coagulation surgical modes. The electrical characteristics of the device 1104 and/or the tissue may be measured and used to control the operational aspects of the generator 1100 and/or be provided as feedback to the user. In aspects in which the generator 1100 is used in conjunction with the device 1106, the drive signal may provide electrical energy (e.g., RF energy) to the end actuator 1124 in cutting, coagulation, and/or desiccation modes. The electrical characteristics of the device 1106 and/or the tissue may be measured and used to control the operational aspects of the generator 1100 and/or be provided as feedback to the user. In many aspects, as previously discussed, hardware components can be implemented as PSD, PLD, ASIC, circuits and/or registers. In one aspect, the processor may be configured to store and execute computer software program instructions to generate step function output signals for driving various components of devices 1104, 1106, 1108, such as the ultrasonic transducer. 1120 and end actuators 1122, 1124, 1125.

[0312] An electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide, and an ultrasonic blade. The electromechanical ultrasonic system has an initial resonance frequency defined by the physical properties of the ultrasonic transducer, the waveguide, and the ultrasonic blade. The ultrasonic transducer is excited by an alternating voltage signal Vg(t) and current Ig(t) equal to the resonant frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is in resonance, the phase difference between the voltage Vg(t) and current Ig(t) signals is zero. In other words, at resonance the inductive impedance is equal to the capacitive impedance. As the ultrasonic blade heats up, the compliance of the ultrasonic blade (modeled as an equivalent capacitance) causes the resonant frequency of the electromechanical ultrasonic system to shift. Therefore, the inductive impedance is no longer equal to the capacitive impedance causing a difference between the drive frequency and the resonance frequency of the electromechanical ultrasonic system. The system is now operating "out of resonance". The difference between the drive frequency and the resonance frequency is manifested as a phase difference between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer. The generator's electronic circuits can easily monitor the phase difference between the voltage Vg(t) and current Ig(t) signals and can continually adjust the drive frequency until the phase difference is once again equal to zero. At this point, the new drive frequency is equal to the resonant frequency of the new electromechanical ultrasonic system. The change in phase and/or frequency can be used as an indirect measurement of the temperature of the ultrasonic blade.

[0313] As shown in Figure 25, the electromechanical properties of the ultrasonic transducer can be modeled as an equivalent circuit comprising a first branch that has a static capacitance and a second "moving" branch that has an inductance, resistance and capacitance connected in series that define the electromechanical properties of a resonator. Known ultrasonic generators may include a tuning inductor to cancel static capacitance at a resonant frequency so that substantially all of the generator drive signal current flows to the moving branch. Consequently, through the use of a tuning inductor, the generator drive signal current represents the moving branch current, and the generator is thus able to control its drive signal to maintain the resonant frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance plot of the ultrasonic transducer to optimize the frequency locking capabilities of the generator. However, the tuning inductor needs to be matched to the specific static capacitance of an ultrasonic transducer at the operating resonance frequency. In other words, a different ultrasonic transducer having a different static capacitance needs a tuning inductor.

[0314] Figure 25 illustrates an equivalent circuit 1500 of an ultrasonic transducer, such as the ultrasonic transducer 1120, according to one aspect. The circuit 1500 comprises a first "motion" branch having, connected in series, inductance Ls, resistance Rs and capacitance Cs that define the electromechanical properties of the resonator, and a second capacitive branch having a static capacitance C0. The drive current Ig(t) can be received from a generator at a drive voltage Vg(t), with the motion current Im(t) flowing through the first branch and the current Ig(t)-Im(t) that flows through the capacitive branch. Controlling the electromechanical properties of the ultrasonic transducer can be achieved by adequately controlling Ig(t) and Vg(t). As explained above, conventional generator architectures may include a tuning inductor Lt (shown in dashed line in Figure 25) to cancel, in a parallel resonance circuit, the static capacitance C0 at a resonant frequency so that substantially all the current output of the Ig(t) generator flows through the motion branch. In this way, control of the current of the movement branch Im(t) is obtained by controlling the current output of the generator Ig(t). The tuning inductor Lt is specific to the static capacitance C0 of an ultrasonic transducer, however, and a different ultrasonic transducer having a different static capacitance requires a different tuning inductor Lt. Furthermore, how does the tuning inductor Lt correlate to the nominal value of the static capacitance C0 at a single resonant frequency, accurate control of the motion branch current Im(t) is guaranteed only at that frequency. As frequency shifts downward with transducer temperature, accurate control of motion branch current becomes compromised.

[0315] Forms of generator 1100 may not feature a tuning inductor Lt to monitor the motion branch current Im(t). Instead, generator 1100 may use the measured value of static capacitance C0 between applications of power to a specific ultrasonic surgical device 1104 (along with drive signal voltage and current feedback data) to determine output current values. movement branch Im(t) on a dynamic and continuous basis (e.g. in real time). These forms of the generator 1100 are therefore capable of providing virtual tuning to simulate a system that is tuned or resonant with any value of static capacitance C0 at any frequency, and not just at a single resonant frequency imposed by a nominal value of the capacitance. static C0.

[0316] Figure 26 is a simplified block diagram of one aspect of the generator 1100, to provide inductorless tuning as described above, among other benefits. Figures 27A to 27C illustrate an architecture of the generator 1100 of Figure 26, in accordance with one aspect. Referring to Figure 26, the generator 1100 may comprise a patient isolated stage 1520 in communication with a non-isolated stage 1540 via a power transformer 1560. A secondary winding 1580 of the power transformer 1560 is contained in the isolated stage 1520 and may comprise a tapped configuration (e.g., a center-tapped or non-center-tapped configuration) for defining drive signal outputs 1600a, 1600b, 1600c so as to provide output drive signals to different surgical devices, such as an ultrasonic surgical device 1104 and an electrosurgical device 1106. In particular, the drive signal outputs 1600a, 1600b and 1600c may provide a drive signal (e.g., a drive signal at 420 V RMS) to an ultrasonic instrument 1104, and the drive signal outputs 1600a, 1600b, and 1600c may provide a drive signal (e.g., a drive signal at 100 V RMS) to an electrosurgical device 1106, with the output 1600b corresponding to the center tap of the power transformer 1560 The non-isolated stage 1540 may comprise a power amplifier 1620 that has an output connected to a primary winding 1640 of the power transformer 1560. In certain aspects, the power amplifier 1620 may comprise a push-pull type amplifier, for example. . The non-isolated stage 1540 may further comprise a programmable logic device 1660 for providing a digital output to a digital-to-analog converter (DAC) 1680 which, in turn, provides a corresponding analog signal to an input of the power amplifier 1620 In certain aspects, the programmable logic device 1660 may comprise a field programmable gate array (FPGA), for example. The programmable logic device 1660, by controlling the input of the power amplifier 1620 through the DAC 1680, can therefore control any of a number of parameters (e.g., frequency, waveform, waveform amplitude) of drive signals appearing at drive signal outputs 1600a, 1600b and 1600c. In certain aspects and as discussed below, the programmable logic device 1660, in conjunction with a processor (e.g., the processor 1740 discussed below), may implement a number of control algorithms based on digital signal processing (DSP) and/or or other control algorithms for control parameters of drive signals provided by generator 1100.

[0317] Power may be supplied to a power amplifier supply rail 1620 by a switch mode regulator 1700. In certain aspects, the switch mode regulator 1700 may comprise an adjustable antagonistic regulator, for example. As discussed above, the non-isolated stage 1540 may further comprise a processor 1740 which, in one aspect may comprise a DSP processor such as an ADSP-21469 SHARC DSP, available from Analog Devices, Norwood, Mass., USA, for example. . In certain aspects, the processor 1740 may control the operation of the switch mode power converter 1700 responsive to voltage feedback data received from the power amplifier 1620 by the processor 1740 via an analog-to-digital converter (DAC) 1760 In one aspect, for example, the processor 1740 may receive as input, via the AD converter 1760, the waveform envelope of a signal (e.g., an RF signal) being amplified by the power amplifier 1620. The processor. 1740 may then control the switch mode regulator 1700 (e.g., via a pulse-width modulated (PWM) output) so that the rail voltage supplied to the power amplifier 1620 follows the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of the power amplifier 1620 based on the waveform envelope, the efficiency of the power amplifier 1620 can be significantly improved over a voltage amplifier scheme. fixed rail. The 1740 processor can be configured for wired or wireless communication.

[0318] In certain aspects and as discussed in further detail in connection with Figures 28A to 28B, the programmable logic device 1660, in conjunction with the processor 1740, may implement a direct digital synthesizer (DDS) control scheme to control the waveform, the frequency and/or amplitude of the supply of drive signals by the generator 1100. In one aspect, for example, the programmable logic device 1660 may implement a DDS control algorithm 2680 (Figure 28A) by recovering waveform samples stored in a dynamically updated lookup table (LUT), such as a RAM LUT that can be integrated into an FPGA. This control algorithm is particularly useful for ultrasonic applications in which an ultrasonic transducer, such as the 1120 ultrasonic transducer, can be driven by a clean sinusoidal current at its resonant frequency. Since other frequencies can excite parasitic resonances, minimizing or reducing the total distortion of the motion branch current can correspondingly minimize or reduce the undesirable effects of the resonance. Because the waveform of a drive signal output by generator 1100 is impacted by various sources of distortion present in the output drive circuit (e.g., power transformer 1560, power amplifier 1620), feedback data voltage and current based on the drive signal may be fed to an algorithm, such as an error control algorithm implemented by processor 1740, that compensates for distortion by appropriately pre-distorting or modifying the waveform samples stored in the LUT in a dynamic and continuous manner (for example, in real time). In one aspect, the amount or degree of pre-distortion applied to the LUT samples may be based on the error between a computed motion branch current and a desired current waveform, wherein the error is determined on a basis of sample by sample. In this way, the pre-distorted LUT samples, when processed through the drive circuit, can result in a motion branch drive signal that has the desired waveform (e.g., sinusoidal) to optimally drive the transducer. ultrasonic. In such aspects, the LUT waveform samples will therefore not represent the desired waveform of the drive signal, but rather the waveform that is necessary to ultimately produce the desired waveform of the signal. of the movement branch, when distortion effects are taken into account.

[0319] The non-isolated stage 1540 may further comprise an A-D converter 1780 and an A-D converter 1800 coupled to the output of the power transformer 1560 through respective isolation transformers, 1820 and 1840, to sample voltage and current, respectively. of drive signals output by the generator 1100. In certain aspects, the A-D converters 1780 and 1800 can be configured to sample at high speeds (e.g., 80 Msps) to enable oversampling of the drive signals. In one aspect, for example, the sampling speed of the 1780 and 1800 A-D converters can enable approximately 200X oversampling (depending on the drive frequency) of the drive signals. In certain aspects, sampling operations of the ADCs 1780, 1800 may be performed by a single ADC receiving input voltage and current signals through a bidirectional multiplexer. The use of high-speed sampling in aspects of the generator 1100 may enable, among other things, calculation of the complex current flowing through the motion branch (which may be used in certain aspects to implement the DDS-based waveform control described above), accurate digital filtering of sampled signals, and calculation of actual power consumption with a high degree of accuracy. The voltage and current feedback data output by the A-D converters 1780 and 1800 may be received and processed (e.g., FIFO buffering, multiplexing) by the programmable logic device 1660 and stored in data memory for subsequent retrieval. for example, by processor 1740. As noted above, voltage and current feedback data can be used as input to an algorithm for pre-distorting or modifying waveform samples in the LUT, in a dynamic and continuous manner. In certain aspects, this may require that each stored voltage and current feedback data pair be indexed based on, or otherwise associated with, a corresponding LUT sample that was provided by programmable logic device 1660 when the data pair of voltage and current feedback was captured. Synchronizing the LUT samples with the voltage and current feedback data in this way contributes to the correct timing and stability of the pre-distortion algorithm.

[0320] In certain aspects, voltage and current feedback data may be used to control the frequency and/or amplitude (e.g., current amplitude) of drive signals. In one aspect, for example, the voltage and current feedback data can be used to determine the phase of the impedance, e.g., the phase difference between the voltage and current drive signals. The frequency of the drive signal can then be controlled to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (e.g., 0°), thereby minimizing or reducing the effects of harmonic distortion. and, correspondingly, enhancing the accuracy of the impedance phase measurement. Phase impedance determination and a frequency control signal may be implemented in processor 1740, for example, with the frequency control signal being provided as input to a DDS control algorithm implemented by programmable logic device 1660.

[0321] The phase of the impedance can be determined using Fourier analysis. In one aspect, the phase difference between the drive signals of the generated voltage Vg(t) and the generated current Ig(t) can be determined using the fast Fourier transform (FFT) or the discrete Fourier transform. (DFT) as set out below:

[0322] Evaluation of the Fourier transform at the sinusoid frequency yields:

[0323] Other approaches include weighted least squares estimation, Kalman filtering, and space- and vector-based techniques. Virtually all processing in an FFT or DFT technique can be performed in the digital domain with the aid of the two-channel high-speed ADC, 1780,1800, for example. In one technique, digital signal samples of voltage and current signals are Fourier transformed with an FFT or a DFT. The phase angle Φ at any point in time can be calculated by: where Φ is the phase angle, f is the frequency, t is the time, and Φ0 is the phase at t = 0.

[0324] Another technique for determining the phase difference between voltage Vg(t) and current Ig(t) signals is the zero-crossing method and produces highly accurate results. For voltage signals Vg(t) and current Ig(t) having the same, each zero crossing from negative to positive of the voltage signal Vg(t) triggers the start of a pulse, while each zero crossing from negative to positive of the current signal Ig(t) triggers the end of the pulse. The result is a train of pulses with a pulse width proportional to the phase angle between the voltage signal and the current signal. In one aspect, the pulse train can be passed through an averaging filter to produce a measure of the phase difference. Furthermore, if positive to negative zero crossings are also used in a similar way, and the results averaged, any effects of DC and harmonic components can be reduced. In one implementation, analog voltage Vg(t) and current Ig(t) signals are converted to digital signals that are high if the analog signal is positive and low if the analog signal is negative. Highly accurate phase estimates require sharp transitions between highs and lows. In one aspect, a Schmitt trigger together with an RC stabilization network can be used to convert analog signals into digital signals. In other aspects, an edge-triggered RS flip-flop circuit and auxiliaries can be used. In yet another aspect, the zero-crossing technique can use an eXclusive (XOR) gate.

[0325] Other techniques for determining the phase difference between voltage and current signals include Lissajous figures and image monitoring; methods such as the three-voltmeter method, the "crossed-coil" method, the vector voltmeter and vector impedance methods; and the use of standard phase instruments, phase-locked loops, and other techniques as described in Phase Measurement, Peter O'Shea, 2000 CRC Press LLC, <http://www.engnetbase. com>, which is incorporated herein by reference.

[0326] In another aspect, for example, current feedback data may be monitored so as to maintain the current amplitude of the drive signal at a current amplitude set point. The current amplitude setpoint can be specified directly or determined indirectly based on the specified setpoints for voltage and power amplitude. In certain aspects, control of the current amplitude may be implemented by the control algorithm, such as a proportional-integral-derivative (PID) control algorithm, in the processor 1740. The variables controlled by the control algorithm to adequately control the current amplitude of the drive signal may include, for example, scaling the LUT waveform samples stored in the programmable logic device 1660 and/or the full-scale output voltage of the A-D converter 1680 (which provides input to the drive amplifier). power 1620) through an A-D converter 1860.

[0327] The non-isolated stage 1540 may further contain a processor 1900 to provide, among other things, user interface (UI) functionality. In one aspect, the processor 1900 may comprise an Atmel AT91 SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation of San Jose, California, USA, for example. Examples of UI functionality supported by processor 1900 may include audible and visual user feedback, communication with peripheral devices (e.g., via a universal serial bus (USB) interface), communication with footswitch 1430, communication with a data input device 2150 (e.g., a touch screen) and communicating with an output device 2140 (e.g., a speaker). The processor 1900 may communicate with the processor 1740 and the programmable logic device (e.g., via serial peripheral interface (SPI) buses). Although the processor 1900 may primarily support UI functionality, it may also coordinate with the processor 1740 to implement risk mitigation in certain aspects. For example, processor 1900 may be programmed to monitor various aspects of user inputs and/or other inputs (e.g., touch screen inputs 2150, footswitch inputs 1430, temperature sensor inputs 2160) and may disable the 1100 generator drive output when an error condition is detected.

[0328] In certain aspects, both the processor 1740 (Figure 26, 27A) and the processor 1900 (Figure 26, 27B) can determine and monitor the operational state of the generator 1100. For the processor 1740, the operational state of the generator 1100 can determine, for example, which control and/or diagnostic processes are implemented by the processor 1740. For the processor 1900, the operational state of the generator 1100 may determine, for example, which elements of a user interface (e.g., monitor screens , sounds) are presented to a user. The processors 1740 and 1900 can independently maintain the current operating state of the generator 1100, as well as recognize and evaluate possible transitions out of the current operating state. Processor 1740 may function as the master in this relationship and may determine when transitions between operational states should occur. Processor 1900 may be aware of valid transitions between operating states and may confirm whether a given transition is appropriate. For example, when processor 1740 instructs processor 1900 to transition to a specific state, processor 1900 may verify that the requested transition is valid. In the event that a requested transition between states is determined to be invalid by processor 1900, processor 1900 may cause generator 1100 to enter a failure mode.

[0329] The non-isolated stage 1540 may further comprise a controller 1960 (Figures 26, 27B) for monitoring input devices 2150 (e.g., a capacitive touch sensor used to turn generator 1100 on and off, a capacitive screen touch sensitive). In certain aspects, the controller 1960 may comprise at least one processor and/or other controlling device in communication with the processor 1900. In one aspect, for example, the controller 1960 may comprise a processor (e.g., an 8-bit Mega168 controller available from Atmel) configured to monitor user-supplied inputs through one or more capacitive touch sensors. In one aspect, the controller 1960 may comprise a touch screen controller (e.g., a QT5480 touch screen controller available from Atmel) to control and manage the capture of touch data from a capacitive touch screen. to the touch.

[0330] In certain aspects, when the generator 1100 is in an "off" state, the controller 1960 may continue to receive operating power (e.g., through a line from a generator power supply 1100, such as the power supply 2110 (Figure 26) discussed below). In this way, the controller 1960 can continue to monitor an input device 2150 (e.g., a capacitive touch sensor located on a front panel of the generator 1100) to turn the generator 1100 on and off. When the generator 1100 is in the off state, The controller 1960 may wake up the power supply (e.g., enable operation of one or more DC/DC voltage converters 2130 (Figure 26) of the power supply 2110) if activation of the "on/off" input device is detected. turns off" 2150 by a user. The controller 1960 may therefore initiate a sequence to transition the generator 1100 to an "on" state. Conversely, the controller 1960 may initiate a sequence to transition the generator 1100 to the off state if activation of the "on/off" input device 2150 is detected when the generator 1100 is in the on state. In certain aspects, for example, the controller 1960 may report the activation of the "on/off" input device 2150 to the processor 1900 which, in turn, implements the process sequence necessary to transition the generator 1100 to the off state. In these aspects, the controller 1960 may not have any independent ability to cause the removal of power from the generator 1100 after its on state has been established.

[0331] In certain aspects, the controller 1960 may cause the generator 1100 to provide audible feedback or other sensory feedback to alert the user that an on or off sequence has been initiated. This type of alert can be provided at the beginning of an on or off sequence, and before the start of other processes associated with the sequence.

[0332] In certain aspects, the isolated stage 1520 may comprise an instrument interface circuit 1980 to, for example, provide a communication interface between a control circuit of a surgical device (e.g., a control circuit comprising switches cable) and components of the non-isolated stage 1540, such as the programmable logic device 1660, the processor 1740, and/or the processor 1900. The instrument interface circuit 1980 may exchange information with components of the non-isolated stage 1540 via a link communication link that maintains an adequate degree of electrical isolation between stages 1520 and 1540, such as an infrared (IR)-based communication link. Power may be supplied to the instrument interface circuit 1980 with the use of, for example, a low dropout voltage regulator fed by an isolation transformer driven from the non-isolated stage 1540.

[0333] In one aspect, the instrument interface circuit 1980 may comprise a programmable logic device 2000 (e.g., an FPGA) in communication with a signal conditioning circuit 2020 (Figure 26 and Figure 27C). The signal conditioning circuit 2020 may be configured to receive a periodic signal from the programmable logic device 2000 (e.g., a 2 kHz square wave) to generate a bipolar interrogation signal that has an identical frequency. The interrogation signal can be generated, for example, using a bipolar current source fed by a differential amplifier. The interrogation signal may be communicated to a control circuit of the surgical device (e.g., through the use of a conductive pair in a wire connecting the generator 1100 to the surgical device) and monitored to determine a state or configuration of the control circuit. . The control circuit may comprise a plurality of switches, resistors and/or diodes for modifying one or more characteristics (e.g., amplitude, rectification) of the interrogation signal so that a state or configuration of the control circuit is unambiguously discernible. based on one or more characteristics. In one aspect, for example, the signal conditioning circuit 2020 may comprise an A-D converter for generating samples of a voltage signal that appears between inputs of the control circuit, resulting from the passage of the interrogation signal therethrough. The programmable logic device 2000 (or a component of the non-isolated stage 1540) may then determine the state or configuration of the control circuit based on the ADC samples.

[0334] In one aspect, the instrument interface circuit 1980 may comprise a first data circuit interface 2040 to enable the exchange of information between the programmable logic device 2000 (or another element of the instrument interface circuit 1980) and a first data circuit disposed in, or otherwise associated with, a surgical device. In certain aspects, for example, a first data circuit 2060 may be disposed in a wire integrally attached to a handle of the surgical device, or in an adapter for interfacing between a specific type or model of surgical device and the generator 1100. In certain aspects, the first data circuit may comprise a non-volatile storage device, such as an electrically erasable programmable read-only memory device (EEPROM). In certain aspects and again with reference to Figure 26, the first data circuit interface 2040 may be implemented separately from the programmable logic device 2000 and comprises a suitable circuitry (e.g., discrete logic devices, a processor) to enable communication between the programmable logic device 2000 and the first data circuit. In other aspects, the first data circuit interface 2040 may be integral with the programmable logic device 2000.

[0335] In certain aspects, the first data circuit 2060 may store information related to the specific surgical device with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical device has been used, and/or any other types of information. This information may be read by instrument interface circuit 1980 (e.g., programmable logic device 2000), transferred to a non-isolated stage component 1540 (e.g., programmable logic device 1660, processor 1740, and/or processor 1900 ) for presentation to a user via an output device 2140 and/or to control a function or operation of the generator 1100. Additionally, any type of information may be communicated to the first data circuit 2060 for storage therein via the first interface of data circuit 2040 (e.g., using programmable logic device 2000). This information may comprise, for example, an updated number of operations in which the surgical device was used and/or the dates and/or times of its use.

[0336] As previously discussed, a surgical instrument may be removable from a handle (e.g., instrument 1106 may be removable from handle 1107) to promote interchangeability and/or disposability of the instrument. In these cases, known generators may be limited in their ability to recognize specific instrument configurations being used, as well as to optimize control and diagnostic processes as needed. Adding readable data circuits to surgical device instruments to address this issue is problematic from a compatibility standpoint, however. For example, it may be impractical to design a surgical device to remain backwards compatible with generators lacking the indispensable data reading functionality due to, for example, different signaling schemes, design complexity, and cost. Other aspects of the instruments address these concerns through the use of data circuits that can be implemented into existing surgical instruments, economically and with minimal design changes to preserve the compatibility of the surgical devices with current generator platforms.

[0337] Additionally, aspects of the generator 1100 may enable communication with instrument-based data circuits. For example, generator 1100 may be configured to communicate with a second data circuit (e.g., a data circuit) contained in an instrument (e.g., instrument 1104, 1106, or 1108) of a surgical device. The instrument interface circuit 1980 may comprise a second data circuit interface 2100 to enable such communication. In one aspect, the second data circuit interface 2100 may comprise a three-state digital interface, although other interfaces may also be used. In certain aspects, the second data circuit may generally be any circuit for transmitting and/or receiving data. In one aspect, for example, the second data circuit may store information relating to the specific surgical instrument with which it is associated. This information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument was used, and/or any other types of information. Additionally or alternatively, any type of information may be communicated to the second data circuit for storage therein via the second data circuit interface 2100 (e.g., using programmable logic device 2000). This information may comprise, for example, an updated number of operations in which the surgical instrument was used and/or the dates and/or times of its use. In certain aspects, the second data circuit may transmit data captured by one or more sensors (e.g., an instrument-based temperature sensor). In certain aspects, the second data circuit may receive data from the generator 1100 and provide an indication to the user (e.g., an LED indication or other visible indication) based on the received data.

[0338] In certain aspects, the second data circuit and the second data circuit interface 2100 may be configured so that communication between the programmable logic device 2000 and the second data circuit may be achieved without the need to provide conductors additional wires for this purpose (e.g., dedicated one-wire leads connecting a handle to the generator 1100). In one aspect, for example, information may be communicated to and from the second data circuit using a one-wire bus communication scheme implemented in existing wiring, such as one of the conductors used transmitting interrogation signals from from the 2020 signal conditioner circuit to a control circuit in one cable. In this way, changes or modifications to the design of the surgical device that might otherwise be necessary are minimized or reduced. Furthermore, because different types of communications can be implemented on a common physical channel (with or without frequency band separation), the presence of a second data circuit can be "invisible" to generators that do not have the essential data reading functionality, which therefore allows backward compatibility of the surgical device instrument.

[0339] In certain aspects, the isolated stage 1520 may comprise at least one blocking capacitor 2960-1 (Figure 27C) connected to the drive signal output 1600b, to prevent the passage of direct current to a patient. A single blocking capacitor may be required to comply with medical regulations and standards, for example. Although failures in single-capacitor designs are relatively uncommon, this type of failure can still have negative consequences. In one aspect, a second blocking capacitor 2960-2 may be placed in series with the blocking capacitor 2960-1, with leakage current from a point between the blocking capacitors 2960-1 and 2960-2 being monitored by, e.g. example, a 2980 ADC for sampling a voltage induced by leakage current. Samples may be received by programmable logic device 2000, for example. Based on changes in leakage current (as indicated by the voltage samples in the aspect ratio of Figure 26), the generator 1100 can determine when at least one of the blocking capacitors 2960-1 and 2960-2 has failed. Consequently, the appearance of Figure 26 may provide a benefit over single-capacitor designs having a single point of failure.

[0340] In certain aspects, the non-isolated stage 1540 may comprise a power supply 2110 for outputting DC power with suitable voltage and current. The power supply may comprise, for example, a 400 W power supply to provide a system voltage of 48 VDC. As discussed above, the power supply 2110 may further comprise one or more DC/DC voltage converters 2130 for receiving output from the power supply to generate DC outputs at the voltages and currents required by the various components of the generator 1100. As discussed above With respect to the controller 1960, one or more of the DC/DC voltage converters 2130 may receive an input from the controller 1960 when activation of the "on/off" input device 2150 by a user is detected by the controller 1960, to enable the operation or activation of the 2130 DC/DC voltage converters.

[0341] Figures 28A and 28B illustrate certain functional and structural aspects of one aspect of the generator 1100. Feedback indicating current and voltage output from the secondary winding 1580 of the power transformer 1560 is received by the A-D converters 1780 and 1800, respectively. As shown, the A-D converters 1780 and 1800 can be implemented in the form of a 2-channel A-D converter and can sample the feedback signals at a high speed (e.g., 80 Msps) to enable oversampling (e.g., approx. 200x oversampling) of the trigger signals. Current and voltage feedback signals may be suitably conditioned in the analog domain (e.g., amplified, filtered) prior to processing by the ADCs 1780 and 1800. Current and voltage feedback samples from the A-D converters 1780 and 1800 may be individually recorded (buffered) and subsequently multiplexed or interleaved into a single data stream within block 2120 of the programmable logic device 1660. In the aspect of Figures 28A and 28B, the programmable logic device 1660 comprises an FPGA.

[0342] Multiplexed current and voltage feedback samples may be received by a parallel data capture port (PDAP) implemented within block 2144 of processor 1740. The PDAP may comprise a packaging unit to implement any of a number of methodologies for correlating feedback samples multiplexed with a memory address. In one aspect, for example, feedback samples corresponding to a specific LUT sample output by the programmable logic device 1660 may be stored in one or more memory addresses that are correlated or indexed to the LUT address in the LUT sample. In another aspect, feedback samples corresponding to a specific LUT sample by programmable logic device 1660 may be stored, along with the LUT address of the LUT sample, in a common memory location. In any case, the feedback samples may be stored so that the address of the LUT sample from which a specific set of feedback samples originated can subsequently be determined. As discussed above, synchronizing the addresses of the LUT samples and feedback samples in this way contributes to the correct timing and stability of the pre-warp algorithm. A direct memory access (DMA) controller implemented in block 2166 of processor 1740 may store the feedback samples (and any LUT sample address data, where applicable) in a designated memory location 2180 of processor 1740 (e.g. , internal RAM).

[0343] Block 2200 of processor 1740 may implement a pre-distortion algorithm to pre-distort or modify LUT samples stored in programmable logic device 1660 in a dynamic and continuous manner. As discussed above, pre-distortion of LUT samples can compensate for various sources of distortion present in the generator output drive circuit 1100. Pre-distorted LUT samples, when processed through the drive circuit will therefore result in a drive signal having the desired waveform (e.g., sinusoidal) to optimally drive the ultrasonic transducer.

[0344] In block 2220 of the pre-distortion algorithm, the current through the movement branch of the ultrasonic transducer is determined. The motion branch current may be determined using Kirchoff's current law based on, for example, current and voltage feedback samples stored in memory location 2180 (which when, appropriately sized, may be representative of Ig and Vg in the model of Figure 25 discussed above), a value of the static capacitance of the ultrasonic transducer C0 (measured or known a priori) and a known value of the drive frequency. A motion branch current sample can be determined for each set of current and voltage feedback samples stored associated with a LUT sample.

[0345] In block 2240 of the pre-distortion algorithm, each current sample from the motion branch determined in block 2220 is compared to a sample of a desired current waveform shape to determine a difference, or amplitude error, of the current waveform. sample, between the compared samples. For this determination, the sample with the desired current waveform shape can be provided, for example, from a waveform LUT 2260 containing amplitude samples for one cycle of a desired current waveform shape. . The specific sample of the 2260 LUT current waveform format used for the comparison can be determined by the LUT sample address associated with the motion branch current sample used in the comparison. Accordingly, the motion branch current input in block 2240 may be synchronized with the input of its associated LUT sample address in block 2240. The LUT samples stored in the programmable logic device 1660 and the LUT samples stored in the 2260 waveforms can therefore be equal in terms of number. In certain aspects, the desired current waveform represented by the LUT samples stored in the waveform LUT 2260 may be a fundamental sine wave. Other waveforms may be desirable. For example, it is contemplated that a fundamental sine wave could be used to drive the main longitudinal movement of an ultrasonic transducer, superimposed on one or more other drive signals at other frequencies, such as a third-order ultrasonic wave to drive at least two resonances. mechanical in order to obtain beneficial vibrations in transverse or other modes.

[0346] Each sample amplitude error value determined in block 2240 may be transmitted to the LUT of the programmable logic device 1660 (shown in block 2280 in Figure 28A) along with an indication of its associated LUT address. Based on the amplitude error sample value and its associated address (and, optionally, the amplitude error sample values for the same previously received LUT address), the LUT 2280 (or other programmable logic device control block 1660) can pre-distort or modify the value of the LUT sample stored at the LUT address so that the sample amplitude error is reduced or minimized. It should be understood that this pre-distortion or modification of each LUT sample in an iterative manner over the LUT address range will cause the waveform of the generator output current to match or adapt to the waveform of the desired current, represented by the LUT 2260 waveform samples.

[0347] Current and voltage amplitude measurements, power measurements, and impedance measurements may be determined in block 2300 of processor 1740, based on current and voltage feedback samples stored in memory location 2180. Prior to By determining these quantities, the feedback samples can be appropriately sized and, in certain aspects, processed through a suitable filter 2320 to remove noise resulting from, for example, the data capture process and induced harmonic components. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal. In certain aspects, filter 2320 may be a finite impulse response (FIR) filter applied in the frequency domain. These aspects can use fast Fourier transform (FFT) of the current and voltage output signals of the drive signal. In certain aspects, the resulting frequency spectrum can be used to provide additional functionality to the generator. In one aspect, for example, the ratio of the second and/or third order harmonic component to the fundamental frequency component can be used as a diagnostic indicator.

[0348] In block 2340 (Figure 28B), a mean quadratic (RMS) calculation may be applied to a sample size of the current feedback samples representing an integral number of cycles of the drive signal, to generate an Irms measurement. representing the output current of the drive signal.

[0349] In block 2360, a root mean square (RMS) calculation may be applied to a sample size of the voltage feedback samples representing an integral number of cycles of the drive signal, to determine a Vrms measurement representing the voltage of drive signal output.

[0350] In block 2380, the current and voltage feedback samples may be multiplied point by point, and an average calculation is applied to the samples representing an integral number of cycles of the drive signal, to determine a Pr measurement of the drive energy. actual generator output.

[0351] In block 2400, the Pa measurement of the apparent output power of the generator can be determined as the product Vms-Irms.

[0352] In block 2420, the Zm measurement of the magnitude of the load impedance can be determined as the quotient Vrms/Irms.

[0353] In certain aspects, the quantities lrms, Vrms, Pr, Pa and Zm determined in blocks 2340, 2360, 2380, 2400 and 2420, can be used by the generator 1100 to implement any of a number of control processes and/or diagnostics. In certain aspects, any such quantities may be communicated to a user via, for example, an output device 2140 integral with the generator 1100, or an output device 2140 connected to the generator 1100 via a suitable communication interface (e.g. example, a USB interface). The various diagnostic processes may include, without limitation, cable integrity, instrument integrity, instrument fixture integrity, instrument overload, instrument overload proximity, frequency lock failure, over voltage condition, over voltage condition, current, over power condition, voltage sensor failure, current sensor failure, audio indication failure, visual indication failure, short circuit condition, power supply failure, or blocking capacitor failure, for example.

[0354] Block 2440 of processor 1740 may implement a phase control algorithm for determining and controlling the phase of the impedance of an electrical load (e.g., the ultrasonic transducer) driven by the generator 1100. As discussed above, when controlling the frequency of the drive signal to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (e.g. 0°), the effects of harmonic distortion can be minimized or reduced, and measurement accuracy is increased phase.

[0355] The phase control algorithm receives, as input, current and voltage feedback samples stored in memory location 2180. Prior to their use in the phase control algorithm, the feedback samples may be appropriately sized and, in certain aspects, processed through a suitable filter 2460 (which may be identical to filter 2320) to remove noise resulting from the data capture process and induced harmonic components, for example. The filtered voltage and current samples can therefore substantially represent the fundamental frequency of the generator drive output signal.

[0356] In block 2480 of the phase control algorithm, the current through the movement branch of the ultrasonic transducer is determined. This determination may be identical to that described above with respect to block 2220 of the pre-distortion algorithm. In this way, the output of block 2480 may be, for each set of current and voltage feedback samples stored associated with a LUT sample, a current sample from the motion branch.

[0357] In block 2500 of the phase control algorithm, the impedance phase is determined based on the synchronized input of motion branch current samples determined in block 2480 and corresponding to voltage feedback samples. In certain aspects, the impedance phase is determined as the average of the impedance phase measured at the rising edge of the waveforms and the impedance phase measured at the falling edge of the waveforms.

[0358] In block 2520 of the phase control algorithm, the impedance phase value determined in block 2220 is compared to the phase set point 2540 to determine a difference, or phase error, between the compared values.

[0359] In block 2560 (Figure 28A) of the phase control algorithm, based on a phase error value determined in block 2520 and the impedance magnitude determined in block 2420, a frequency output is determined to control the frequency of the trigger signal. The value of the frequency output may be continuously adjusted by block 2560 and transferred to a DDS control block 2680 (discussed below) so as to maintain the phase of the impedance determined in block 2500 of the phase set point (e.g., error of phase zero). In certain aspects, the phase of the impedance can be adjusted to a 0° phase set point. In this way, any harmonic distortion will be centered around the crest of the voltage waveform, enhancing the accuracy of determining the phase impedance.

[0360] Block 2580 of processor 1740 may implement an algorithm for modulating the current amplitude of the drive signal so as to control the current, voltage, and power of the drive signal in accordance with specified set points by the user, or according to requirements specified by other processes or algorithms implemented by the generator 1100. Control of these quantities can be performed, for example, by sizing the LUT samples in the LUT 2280, and/or by adjusting the output voltage. full-scale output of the A-D converter 1680 (which provides input to the power amplifier 1620) via an A-D converter 1860. The block 2600 (which may be implemented as a PID controller in certain respects) may receive as input feedback samples current (which may be appropriately sized and filtered) from memory location 2180. The current feedback samples may be compared to the "current demand" value Id determined by the controlled variable (e.g., current, voltage, or power ) to determine if the drive signal is supplying the required current. In aspects where the drive signal current is the control variable, the current demand Id can be specified directly by a current setpoint 2620A (Isp). For example, an RMS value of the current feedback data (determined as in block 2340) may be compared to the user-specified RMS current setpoint Isp to determine appropriate action for the controller. If for example the current feedback data indicates an RMS value less than the Isp current set point, scaling of the LUT and/or full scale output voltage of the DAC 1680 may be adjusted by block 2600 so that it is the drive signal current is increased. Conversely, block 2600 may adjust a scaling of the LUT and/or the full-scale output voltage of the DAC 1680 to decrease the drive signal current when the current feedback data indicates an RMS value greater than the set point. current adjustment Isp.

[0361] In aspects where the drive signal voltage is the control variable, the current demand Id can be specified indirectly, for example, based on the current required to maintain a desired voltage reference value 2620B (Vsp ) given the magnitude of load impedance Zm measured in block 2420 (e.g., Id = Vsp/Zm). Similarly, in aspects where the drive signal power is the control variable, the current demand Id can be specified indirectly, for example, based on the current required to maintain a desired power setpoint 2620C ( Psp) given the voltage Vrms measured on the 2360 blocks (e.g., Id = Psp/Vrms).

[0362] Block 2680 (Figure 28A) may implement a DDS control algorithm to control the drive signal by retrieving LUT samples stored in LUT 2280. In certain aspects, the DDS control algorithm may be an oscillator algorithm numerically-controlled oscillator (NCO) to generate samples of a waveform at a fixed timing rate using a point-skipping technique. The NCO algorithm may implement a phase accumulator, or frequency-to-phase converter, that functions as an address pointer for retrieving LUT samples from the 2280 LUT. In one aspect, the phase accumulator may be a dimension of the frequency D, modulus N, where D is a positive integer representing a frequency control value, and N is the number of LUT samples in the LUT 2280. A frequency control value D=1, for example, can cause phase accumulator points sequentially to each address of the LUT 2280, resulting in a waveform output that replicates the waveform stored in the LUT 2280. When D>1, the phase accumulator may skip addresses in the LUT 2280, resulting into a waveform output that has a higher frequency. Consequently, the frequency of the waveform generated by the DDS control algorithm can therefore be controlled by appropriately varying the frequency control value. In certain aspects, the frequency control value may be determined based on the output of the phase control algorithm implemented in block 2440. The output of block 2680 may provide the input of DAC 1680, which in turn provides an analog signal. corresponding to a power amplifier input 1620.

[0363] Block 2700 of processor 1740 may implement a switch mode converter control algorithm to dynamically modulate the rail voltage of the power amplifier 1620 based on the waveform envelope of the signal being amplified, thereby improving efficiency. of power amplifier 1620. In certain aspects, waveform envelope characteristics can be determined by monitoring one or more signals contained in power amplifier 1620. In one aspect, for example, waveform envelope characteristics wave can be determined by monitoring the minimum of a drain voltage (e.g., a MOSFET drain voltage) that is modulated according to the envelope of the amplified signal. A minimum voltage signal can be generated, for example, by a voltage minimum detector coupled to the drain voltage. The minimum voltage signal may be sampled by the A-D converter 1760, with the minimum output voltage samples being received in block 2720 of the switching mode converter control algorithm. Based on the values of the minimum voltage samples, block 2740 may control a pulse width modulation signal output by a pulse width modulation generator 2760 which, in turn, controls the voltage bus supplied to the amplifier. power 1620 by the switching mode regulator 1700. In certain aspects, as long as the minimum voltage sample values are less than a minimum target input 2780 in block 2720, the voltage bus can be modulated according to the voltage envelope. waveform as characterized by the minimum voltage samples. When the minimum voltage samples indicate low envelope power levels, for example, the 2740 block may cause a low bus voltage to be supplied to the power amplifier 1620, with the full bus voltage being supplied only when the voltage samples Minimum values indicate maximum envelope power levels. When the minimum voltage samples fall below the target for the minimum 2780, the block 2740 may cause the bus voltage to be maintained at a suitable minimum value to ensure proper operation of the power amplifier 1620.

[0364] Figure 29 is a schematic diagram of an aspect of an electrical circuit 2900, suitable for driving an ultrasonic transducer, such as the ultrasonic transducer 1120, in accordance with at least one aspect of the present description. The electrical circuit 2900 comprises an analog multiplexer 2980. The analog multiplexer 2980 multiplexes various signals from the upstream channels SCL-A, SDA-A, such as ultrasonic, battery and power control circuit. A 2982 current sensor is coupled in series to the return or ground leg of the power supply circuit to measure the current supplied by the power supply. A 2984 field effect transistor (FET) temperature sensor provides the ambient temperature. A 2988 pulse width modulation (PWM) watchdog timer automatically generates a system reset if the main program fails to periodically repair it. It is provided to automatically restart the 2900 electrical circuit when it hangs or freezes due to a software or hardware failure. It will be recognized that the electrical circuit 2900 can be configured as an RF driver circuit to drive the ultrasonic transducer or to drive the RF electrodes like the electrical circuit 3600 shown in Figure 36, for example. Consequently, with reference now again to Figure 29, the electrical circuit 2900 can be used to interchangeably drive the ultrasonic transducers and the RF electrodes. If driven simultaneously, filter circuits may be provided in corresponding first stage circuits 3404 (Figure 34) to select both the ultrasonic waveform and the RF waveform. These filtering techniques are described in commonly owned US Patent Application Publication No. US-2017-0086910-A1 entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is incorporated herein by reference in its entirety.

[0365] A drive circuit 2986 provides left and right ultrasonic power outputs. A digital signal representing the signal waveform is supplied to the SCL-A, SDA-A inputs of the analog multiplexer 2980 from a control circuit such as control circuit 3200 (Figure 32). A digital-to-analog converter (A-D converter) 2990 converts the digital input to an analog output to generate a pulse width modulation circuit 2992 coupled to an oscillator 2994. The pulse width modulation circuit 2992 provides a first signal to a first gate drive circuit 2996a coupled to a first transistor output stage 2998a to drive a first ultrasonic power output (left). The pulse width modulation circuit 2992 also provides a second signal to a second gate drive circuit 2996b coupled to a second transistor output stage 2998b to drive a second ultrasonic power output (right). A 2999 voltage sensor is coupled between the left/right ultrasonic output terminals to measure the output voltage. The driver circuit 2986, the first and second driver circuits 2996a, 2996b, and the first and second transistor output stages 2998a, 2998b define a first stage amplifier circuit. In operation, the control circuit 3200 (Figure 32) generates a digital waveform 4300 (Figure 43) that uses circuits such as digital direct synthesis (DDS) circuits 4100, 4200 (Figures 41 and 42). The 2990 DAC receives the 4300 digital waveform and converts it to an analog waveform, which is received and amplified by the first stage amplifier circuit.

[0366] Figure 30 is a schematic diagram of the transformer 3000 coupled to the electrical circuit 2900 shown in Figure 29, in accordance with at least one aspect of the present description. The left/right ultrasonic input terminals (primary winding) of transformer 3000 are electrically coupled to the left/right ultrasonic output terminals of electrical circuit 2900. The secondary winding of transformer 3000 is coupled to positive and negative electrodes 3074a, 3074b. The positive and negative electrodes 3074a, 3074b of the transformer 3000 are coupled to the positive terminal (Stack 1) and the negative terminal (Stack 2) of the ultrasonic transducer. In one aspect, transformer 3000 has an n1:n2 turns ratio of 1:50.

[0367] Figure 31 is a schematic diagram of the transformer 3000 shown in Figure 30 coupled to a test circuit 3165, in accordance with an aspect of the present description. Test circuit 3165 is coupled to positive and negative electrodes 3074a, 3074b. A 3167 switch is placed in series with an inductor/capacitor/resistor (LCR) load that simulates the load of an ultrasonic transducer.

[0368] Figure 32 is a schematic diagram of a control circuit 3200, such as control circuit 3212, in accordance with at least one aspect of the present description. The 3200 control circuit is located inside a battery pack compartment. The battery pack is the power source for a variety of local power supplies 3215. The control circuitry comprises a main processor 3214 coupled via a master interface 3218 to various downstream circuits via the SCL-A and SDA-A, SCL-B and SDA-B, SCL-C and SDA-C, for example. In one aspect, the 3218 interface master is a general purpose serial interface, such as an I2C serial interface. The main processor 3214 is also configured to drive switches 3224 via general purpose input/output (GPIO) 3220, a display 3226 (e.g., an LCD screen), and various indicators 3228 via GPIO 3222. surveillance 3216 is provided to control the main processor 3214. A switch 3230 is provided in series with a battery 3211 to activate the control circuit 3212 upon insertion of the battery pack into a handle assembly of a surgical instrument.

[0369] In one aspect, the main processor 3214 is coupled to the electrical circuit 2900 (Figure 29) via output terminals SCL-A/SDA-A. The main processor 3214 comprises a memory for storing tables of drive signals or digitized waveforms that are transmitted to the electrical circuit 2900 to drive the ultrasonic transducer 1120, for example. In other aspects, the main processor 3214 may generate a digital waveform and transmit it to the electrical circuit 2900 or may store the digital waveform for later transmission to the electrical circuit 2900. The main processor 3214 may also provide RF triggering by via SCL-B/SDA-B output terminals and various sensors (e.g. Hall effect sensors, magnetorheological fluid (MRF) sensors, etc.) via SCL-C/SDA-C output terminals . In one aspect, the main processor 3214 is configured to detect the presence of ultrasonic drive circuitry and/or RF drive circuitry to enable appropriate software and user interface functionality.

[0370] In one aspect, the main processor 3214 may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a transfer buffer for optimize performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with the StellarisWare® program, electrically erasable programmable read-only memory (EEPROM) 2 KB, one or more pulse width modulation (PWM) modules, one or more analog quadrature encoder (QED) input, one or more 12-bit analog-to-digital converters (ADC) with 12 analog input channels , among other resources that are readily available in the product data sheet. Other processors can be easily replaced and, consequently, the present description should not be limited in this context.

[0371] Figure 33 shows a simplified circuit block diagram illustrating another electrical circuit 3300 contained within a modular ultrasonic surgical instrument 3334, in accordance with an aspect of the present description. The electrical circuit 3300 includes a processor 3302, a clock 3330, a memory 3326, a power supply 3304 (e.g., a battery), a switch 3306, such as a semiconductor metal oxide field effect transistor power switch ( MOSFET), a drive circuit 3308 (PLL), a transformer 3310, a signal smoothing circuit 3312 (also called a matching circuit and may be, for example, a tank circuit), a detection circuit 3314, a transducer 1120, and a drive shaft assembly (e.g., drive shaft assembly 1126, 1129) comprising an ultrasonic transmission waveguide terminating in an ultrasonic blade (e.g., ultrasonic blade 1128, 1149) that can be called, in the present invention, simply a waveguide.

[0372] A feature of the present disclosure that breaks the dependence on high voltage (120 VAC) input power (a characteristic of general ultrasonic cutting devices) is the utilization of low voltage switching throughout the entire process of forming wave and the amplification of the drive signal only directly before the transformer stage. Therefore, in one aspect of the present disclosure, power is derived from just one battery, or group of batteries, small enough to fit inside a grip assembly. State-of-the-art battery technology provides powerful batteries a few centimeters high and wide and a few millimeters deep. By combining the features of the present disclosure to provide a self-contained and self-powered ultrasonic device, a reduction in production cost can be achieved.

[0373] The output of the power supply 3304 is fed to the processor 3302 and powers it. The processor 3302 receives and sends signals and, as will be described below, operates according to custom logic or according to computer programs that are executed by the processor 3302. As discussed above, the electrical circuit 3300 may also include a memory 3326, preferably a random access memory (RAM) that stores computer-readable instructions and data.

[0374] The output of the power supply 3304 is also directed to the switch 3306 having a duty cycle controlled by the processor 3302. By controlling the dwell time of the switch 3306, the processor 3302 is able to determine the total amount of power that is , ultimately supplied to transducer 1120. In one aspect, switch 3306 is a MOSFET, although other switch and switching configurations are also adaptable. The output of the switch 3306 is fed to a drive circuit 3308 that contains, for example, a phase-to-phase-locked (PLL) detection circuit and/or a low-pass filter and/or a voltage-controlled oscillator. The output of switch 3306 is sampled by processor 3302 to determine the voltage and current of the output signal (VIN and IIN, respectively). These values are used in a feedback architecture to adjust the pulse width modulation of the switch 3306. For example, the duty cycle of the switch 3306 can vary from about 20% to about 80% depending on the desired and actual output. from key 3306.

[0375] The drive circuit 3308, which receives the signal from the switch 3306, includes an oscillatory circuit that transforms the output of the switch 3306 into an electrical signal having an ultrasonic frequency, for example, 55 kHz (VCO). As explained above, a smoothed version of this ultrasonic waveform is ultimately fed to the ultrasonic transducer 1120 to produce a resonant sine wave along the ultrasonic transmission waveguide.

[0376] At the output of the drive circuit 3308 there is a transformer 3310 that is capable of raising the low voltage signal(s) to a higher voltage. It is noted that the upstream switching, before the 3310 transformer, is performed at low voltages (e.g. battery driven), something that, until now, has not been possible for ultrasonic cutting and cauterizing devices. This is, at least partially, due to the fact that the device advantageously uses low-resistance MOSFET switching devices. Low-resistance MOSFET switches are advantageous, as they produce lower switching losses and less heat than a traditional MOSFET device and allow greater current to pass through. Therefore, the switching stage (pre-transformer) can be characterized as low voltage/high current. To ensure the lowest resistance of the amplifier's MOSFET(s), the MOSFET(s) is run, for example, at 10 V. In this case, a 10 VDC power supply A separate switch can be used to power the MOSFET gate, which ensures that the MOSFET is fully turned on and that a reasonably low resistance is achieved. In one aspect of the present disclosure, transformer 3310 raises the battery voltage to 120 V root mean square (RMS). Transformers are known in the art and are therefore not explained in detail here.

[0377] In the described circuit configurations, circuit component degradation may negatively affect the circuit performance of the circuit. One factor that directly affects component performance is heat. Known circuits generally monitor switching temperatures (i.e., MOSFET temperatures). However, due to technological advances in MOSFET designs and due to the corresponding reduction in size, MOSFET temperatures are no longer a valid indicator of circuit loads and heat. For this reason, according to at least one aspect of the present description, a detection circuit 3314 detects the temperature of the transformer 3310. This temperature detection is advantageous because the transformer 3310 is operated at or very close to its maximum temperature. while using the device. The additional temperature will cause the core material, for example ferrite, to rupture and permanent damage may occur. The present disclosure may respond to a maximum temperature of the transformer 3310, for example, by reducing the drive power in the transformer 3310, signaling the user, turning off the power, pulsing the power, or through other appropriate responses.

[0378] In one aspect of the present disclosure, the processor 3302 is communicatively coupled to the end actuator (e.g., 1122, 1125) that is used to place the material in physical contact with the ultrasonic blade (e.g., 1128, 1149). Sensors are provided that measure, at the end actuator, a locking force value (existing within a known range) and, based on the received locking force value, the 3302 processor varies the VM movement voltage. Since high values of force, combined with a defined rate of motion, can result in high blade temperatures, a temperature sensor 3332 may be communicatively coupled to the processor 3302, wherein the processor 3302 is operable to receive and interpret a signal indicating a current blade temperature from the temperature sensor 3336 and to determine a target frequency of blade movement based on the received temperature. In another aspect, force sensors, such as mechanical tension gauges or pressure sensors, can be coupled to the trigger (e.g., 1143, 1147) to measure the force applied to the trigger by the user. In another aspect, force sensors, such as mechanical strain gauges or pressure sensors, can be coupled to a switch button so that the magnitude of displacement corresponds to the force applied by the user to the switch button.

[0379] According to at least one aspect of the present description, the PLL portion of the drive circuit 3308, which is coupled to the processor 3302, is capable of determining a waveguide movement frequency and communicating that frequency to the processor 3302. Processor 3302 stores the value of this frequency in memory 3326 when the device is turned off. By reading the clock 3330, the processor 3302 is able to determine an elapsed time after the device is turned off and recover the last moving frequency of the waveguide if the elapsed time is less than a predetermined value. The device can then start at the latter frequency, which presumably is the optimal frequency for charging current.

Modular Battery-Powered Handheld Surgical Instrument with Multi-Stage Generator Circuits

[0380] In another aspect, the present disclosure provides a battery-powered modular handheld surgical instrument with multistage generator circuits. A surgical instrument is described that includes a battery assembly, a handle assembly, and a drive shaft assembly, wherein the battery assembly and the drive shaft assembly are configured to mechanically and electrically connect the handle assembly. The drum set includes a control circuit configured to generate a digital waveform. The handle assembly includes a first stage circuit configured to receive the digital waveform, convert the digital waveform to an analog waveform, and amplify the analog waveform. The drive shaft assembly includes a second stage circuit coupled to the first stage circuit to receive, amplify, and apply the analog waveform to a load.

[0381] In one aspect, the present description provides a surgical instrument, which comprises: a battery assembly, which comprises a control circuit comprising a battery, a memory coupled to the battery, and a processor coupled to the memory and the battery, wherein the processor is configured to generate a digital waveform; a handle assembly comprising a first stage circuit coupled to the processor, wherein the first stage circuit comprises a digital to analog converter (DAC) and a first amplifier stage circuit, wherein the DAC is configured to receive the form of digital wave and converting the digital waveform into an analog waveform, wherein the first stage amplifier circuit is configured to receive and amplify the analog waveform; and a drive shaft assembly comprising a second stage circuit coupled to the first stage amplifier circuit for receiving the analog waveform, amplifying the analog waveform, and applying the analog waveform to a load; wherein the battery assembly and drive shaft assembly are configured to mechanically and electrically connect to the grip assembly.

[0382] The payload may comprise any of an ultrasonic transducer, an electrode or a sensor, or any combinations thereof. The first stage circuit may comprise an ultrasonic drive first stage circuit and a high frequency current drive first stage circuit. The control circuit may be configured to drive the first ultrasonic drive stage circuit and the first high frequency current drive stage circuit independently or simultaneously. The first ultrasonic drive stage circuit may be configured to couple to a second stage ultrasonic drive circuit. The second ultrasonic drive stage circuit can be configured to couple to an ultrasonic transducer. The first stage high frequency current drive stage circuit may be configured to couple with a second high frequency stage circuit. The second high frequency drive stage circuit may be configured to couple to an electrode.

[0383] The first stage circuit may comprise a first sensor drive stage circuit. The first sensor trigger stage circuit may be configured to a second trigger stage circuit. The second sensor drive stage circuit may be configured to couple to a sensor.

[0384] In another aspect, the present description provides a surgical instrument, which comprises: a battery assembly, which comprises a control circuit comprising a battery, a memory coupled to the battery, and a processor coupled to the memory and the battery , wherein the processor is configured to generate a digital waveform; a handle assembly comprising a first common stage circuit coupled to the processor, wherein the first common stage circuit comprises a digital to analog converter (DAC) and a first common stage amplifier circuit, wherein the DAC is configured to receive the digital waveform and converting the digital waveform into an analog waveform, wherein the first common stage amplifier circuit is configured to receive and amplify the analog waveform; and a drive shaft assembly comprising a second stage circuit coupled to the first common stage amplifier circuit for receiving the analog waveform, amplifying the analog waveform, and applying the analog waveform to a load; wherein the battery assembly and drive shaft assembly are configured to mechanically and electrically connect to the grip assembly.

[0385] The payload may comprise any one of an ultrasonic transducer, an electrode or a sensor, or any combinations thereof. The first common stage circuit can be configured to drive ultrasonic, high frequency, or sensor circuits. The first common drive stage circuit may be configured to couple to a second ultrasonic drive stage circuit, a second high frequency drive stage circuit, or a second sensor drive stage circuit. The second ultrasonic drive stage circuit may be configured to couple to an ultrasonic transducer, the second high frequency drive stage circuit is configured to couple to an electrode, and the second sensor drive stage circuit is configured to couple to a sensor.

[0386] In another aspect, the present description provides a surgical instrument, which comprises: a control circuit comprising a memory coupled to a processor, wherein the processor is configured to generate a digital waveform; a handle assembly comprising a first common stage circuit coupled to the processor, the first common stage circuit configured to receive the digital waveform, convert the digital waveform to an analog waveform, and amplify the waveform analog; and a drive shaft assembly comprising a second stage circuit coupled to the common first stage circuit for receiving and amplifying the analog waveform; wherein the drive shaft assembly is configured to mechanically and electrically connect to the grip assembly.

[0387] The first common stage circuit can be configured to drive ultrasonic, high frequency, or sensor circuits. The first common drive stage circuit may be configured to couple to a second ultrasonic drive stage circuit, a second high frequency drive stage circuit, or a second sensor drive stage circuit. The second ultrasonic drive stage circuit may be configured to couple to an ultrasonic transducer, the second high frequency drive stage circuit is configured to couple to an electrode, and the second sensor drive stage circuit is configured to couple to a sensor.

[0388] Figure 34 illustrates a generator circuit 3400 divided into a first stage circuit 3404 and a second stage circuit 3406, in accordance with at least one aspect of the present description. In one aspect, the surgical instruments of the surgical system 1000 described herein may comprise a generator circuit 3400 divided into multiple stages. For example, the surgical instruments of the surgical system 1000 may comprise the generator circuit 3400 divided into at least two circuits: the first stage circuit 3404 and the second stage amplification circuit 3406 allowing operation of RF energy only, ultrasonic energy only. , and/or a combination of RF energy and ultrasonic energy. A combination modular drive shaft assembly 3414 will be powered by the first common stage circuit 3404 located in a grip assembly 3412 and the second modular stage circuit 3406 integral with the modular drive shaft assembly 3414. As previously discussed in this description In connection with the surgical instruments of the surgical system 1000, a battery assembly 3410 and the drive shaft assembly 3414 are configured to mechanically and electrically connect to the handle assembly 3412. The end actuator assembly is configured to mechanically connect and electrically to the 3414 drive shaft assembly.

[0389] Turning now to Figure 34, the generator circuit 3400 is divided into multiple stages located in multiple modular assemblies of a surgical instrument, such as the surgical instruments of the surgical system 1000 described herein. In one aspect, a stage control circuit 3402 may be situated in the battery pack 3410 of the surgical instrument. Stage control circuit 3402 is a control circuit 3200 as described in connection with Figure 32. Control circuit 3200 comprises a processor 3214, which includes internal memory 3217 (Figure 34) (e.g., volatile and non-volatile memory ), and is electrically coupled to a battery 3211. The battery 3211 provides power to the first stage circuit 3404, the second stage circuit 3406, and a third stage circuit 3408, respectively. As previously discussed, the control circuit 3200 generates a digital waveform 4300 (Figure 43) using circuits and techniques described in connection with Figures 41 and 42. Again with reference to Figure 34, the digital waveform 4300 can be configured to drive an ultrasonic transducer, high frequency electrodes (e.g., RF), or a combination thereof, independently or simultaneously. If driven simultaneously, filter circuits may be provided in corresponding first stage circuits 3404 to select both the ultrasonic waveform and the RF waveform. These filtering techniques are described in commonly owned US Patent Application Publication No. US-2017-0086910-A1 entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is incorporated herein by reference in its entirety.

[0390] The first stage circuits 3404 (e.g., the first ultrasonic drive stage circuit 3420, the first RF drive stage circuit 3422, and the first sensor drive stage circuit 3424) are located in a surgical instrument handle set 3412. The control circuit 3200 provides the ultrasonic drive signal to the first ultrasonic drive stage circuit 3420 through the SCL-A, SDA-A outputs of the control circuit 3200. The first ultrasonic drive stage circuit 3420 is described in detail in connection with Figure 29. The control circuit 3200 provides the RF trigger signal to the first RF trigger stage circuit 3422 through the SCL-B, SDA-B outputs of the control circuit 3200. The first stage circuit RF drive stage 3422 is described in detail in connection with Figure 36. Control circuit 3200 provides the sensor drive signal to the first sensor drive stage circuit 3424 via the SCL-C, SDA-C outputs of the RF drive stage circuit 3422. control 3200. In general, each of the first stage circuits 3404 includes a digital-to-analog converter (DAC) and a first stage amplifier section for driving the second stage circuits 3406. The outputs of the first stage circuits 3404 are provided for the inputs of the 3406 second stage circuits.

[0391] Control circuit 3200 is configured to detect which modules are plugged into control circuit 3200. For example, control circuit 3200 is configured to detect whether the first ultrasonic drive stage circuit 3420, the first ultrasonic drive stage circuit RF drive 3422, or the first sensor drive stage circuit 3424 located in the grip assembly 3412 is connected to the battery pack 3410. Likewise, each of the first stage circuits 3404 can detect which second stage circuits 3406 are connected thereto and what information is fed back to the control circuit 3200 to determine what type of signal waveform to generate. Similarly, each of the second stage circuits 3406 can detect which third stage circuits 3408 or components are connected thereto and what information is fed back to the control circuit 3200 to determine what type of signal waveform to generate. .

[0392] In one aspect, the second stage circuits 3406 (e.g., the second ultrasonic drive stage circuit 3430, the second RF drive stage circuit 3432, and the second sensor drive stage circuit 3434) are located on the 3414 drive shaft assembly of the surgical instrument. The first ultrasonic drive stage circuit 3420 provides a signal to the second ultrasonic drive stage circuit 3430 via US-left/US-forward outputs. The second ultrasonic drive stage circuit 3430 is described in detail in connection with Figures 30 and 31. In addition to a transformer (Figures 30 and 31), the second ultrasonic drive stage circuit 3430 may also include a filter, amplifier, and signal conditioning circuits. The first high-frequency current (RF) drive stage circuit 3422 provides a signal to the second RF drive stage circuit 3432 via the RF-left/RF-right outputs. In addition to a transformer and blocking capacitors, the 3432 second RF drive stage circuit may also include filter, amplifier, and signal conditioning circuits. The first sensor drive stage circuit 3424 provides a signal to the second sensor drive stage circuit 3434 via sensor-1/sensor-2 outputs. The second sensor driver stage circuit 3434 may include filter, amplifier, and signal conditioning circuitry depending on the type of sensor. The outputs of the second stage circuits 3406 are provided to the inputs of the third stage circuits 3408.

[0393] In one aspect, third stage circuits 3408 (e.g., ultrasonic transducer 1120, RF electrodes 3074a, 3074b, and sensors 3440) may be located in various sets 3416 of the Surgical Instruments. In one aspect, the second ultrasonic drive stage circuit 3430 provides a drive signal to the piezoelectric stack of the ultrasonic transducer 1120. In one aspect, the ultrasonic transducer 1120 is located in the ultrasonic transducer assembly of the surgical instrument. In other aspects, however, the ultrasonic transducer 1120 may be located in the handle assembly 3412, the drive shaft assembly 3414, or the end actuator. In one aspect, the second RF drive stage circuit 3432 provides a drive signal to RF electrodes 3074a, 3074b, which are generally located on the end actuator portion of the surgical instrument. In one aspect, the second sensor drive stage circuit 3434 provides a drive signal to a plurality of sensors 3440 located on the surgical instrument.

[0394] Figure 35 illustrates a generator circuit 3500 divided into multiple stages in which a first stage circuit 3504 is common to the second stage circuit 3506, in accordance with at least one aspect of the present description. In one aspect, the surgical instruments of the surgical system 1000 described herein may comprise generator circuit 3500 divided into multiple stages. For example, the surgical instruments of the surgical system 1000 may comprise the generator circuit 3500 divided into at least two circuits: the first stage circuit 3504 and the second stage amplification circuit 3506 allowing operation of high frequency RF energy only, energy ultrasonic only, and/or a combination of RF energy and ultrasonic energy. A combination modular drive shaft assembly 3514 will be powered by the first common stage circuit 3504 located in a grip assembly 3512 and the second modular stage circuit 3506 integral with the modular drive shaft assembly 3514. As previously discussed in this description With respect to the surgical instruments of the surgical system 1000, a battery assembly 3510 and the drive shaft assembly 3514 are configured to mechanically and electrically connect to the handle assembly 3512. The end actuator assembly is configured to mechanically and electrically connect to each other. connect to 3514 drive shaft assembly.

[0395] As shown in the example of Figure 35, the battery pack portion 3510 of the surgical instrument comprises a first control circuit 3502, which includes the previously described control circuit 3200. The grip assembly 3512, which connects to the battery pack 3510, comprises a first common drive stage circuit 3420. As previously discussed, the first drive stage circuit 3420 is configured to drive high frequency ultrasonic current (RF). ), and sensor loads. The output of the first common drive stage circuit 3420 may drive any of the second stage circuits 3506 such as the second ultrasonic drive stage circuit 3430, the second high frequency current (RF) drive stage circuit 3432, and /or the second sensor drive stage circuit 3434. The first common drive stage circuit 3420 detects which second stage circuit 3506 is situated in the drive shaft assembly 3514 when the drive shaft assembly 3514 is connected to the assembly. handle assembly 3512. After the drive shaft assembly 3514 is connected to the handle assembly 3512, the first common drive stage circuit 3420 determines which of the second stage circuits 3506 (e.g., the second ultrasonic drive stage circuit 3430, the second RF drive stage circuit 3432, and/or the second sensor drive stage circuit 3434) is located in the drive shaft assembly 3514. Information is provided to the control circuit 3200 located in the drive shaft assembly. handle 3512 to provide a suitable digital waveform 4300 (Figure 43) to the second stage circuit 3506 to drive the appropriate load, e.g., ultrasonic, RF, or sensor. It will be understood that identification circuits may be included in various assemblies 3516 in the third stage circuit 3508 such as the ultrasonic transducer 1120, the electrodes 3074a, 3074b, or the sensors 3440. Thus, when a third stage circuit 3508 is connected to a second stage circuit 3506, the second stage circuit 3506 recognizes the type of load that is required based on the identification information.

[0396] Figure 36 is a schematic diagram of an aspect of an electrical circuit 3600 configured to drive a high frequency (RF) current, in accordance with at least one aspect of the present description. The electrical circuit 3600 comprises an analog multiplexer 3680. The analog multiplexer 3680 multiplexes various signals from the SCL-A, SDA-A upstream channels such as RF, battery and power control circuits. A 3682 current sensor is coupled in series to the return or ground leg of the power supply circuit to measure the current supplied by the power supply. A 3684 field effect transistor (FET) temperature sensor provides the ambient temperature. A 3688 pulse width modulation (PWM) watchdog timer automatically generates a system reset if the main program fails to periodically repair it. It is provided to automatically restart the 3600 electrical circuit when it crashes or freezes due to a software or hardware failure. It will be recognized that the electrical circuit 3600 may be configured to drive RF electrodes or to drive the ultrasonic transducer 1120 as described in relation to Figure 29, for example. Consequently, referring again now to Figure 36, the electrical circuit 3600 can be used to drive both ultrasonic and RF electrodes interchangeably.

[0397] A driver circuit 3686 provides left and right RF power outputs. A digital signal representing the signal waveform is supplied to the SCL-A, SDA-A inputs of the 3680 analog multiplexer from a control circuit such as the 3200 control circuit (Figure 32). A digital-to-analog converter (A-D converter) 3690 converts the digital input to an analog output to generate a pulse width modulation circuit 3692 coupled to an oscillator 3694. The pulse width modulation circuit 3692 provides a first signal to a first gate drive circuit 3696a coupled to a first transistor output stage 3698a to drive a first RF+ power output (left). The pulse width modulation circuit 3692 also provides a second signal to a second gate drive circuit 3696b coupled to a second transistor output stage 3698b to drive a second RF-power output (right). A 3699 voltage sensor is coupled between the left output/RF output terminals to measure the output voltage. The driver circuit 3686, the first and second driver circuits 3696a, 3696b, and the first and second transistor output stages 3698a, 3698b define a first stage amplifier circuit. In operation, the control circuit 3200 (Figure 32) generates a digital waveform 4300 (Figure 43) that uses circuits such as digital direct synthesis (DDS) circuits 4100, 4200 (Figures 41 and 42). The A-D converter 3690 receives the digital waveform 4300 and converts it to an analog waveform, which is received and amplified by the first stage amplifier circuit.

[0398] Figure 37 is a schematic diagram of the transformer 3700 coupled to the electrical circuit 3600 shown in Figure 36, in accordance with at least one aspect of the present description. The RF+/RF (primary winding) input terminals of transformer 3700 are electrically coupled to the left RF/RF output terminals of electrical circuit 3600. One side of the secondary winding is coupled in series to the first and second blocking capacitors 3706, 3708 The second blocking capacitor is coupled to the positive terminal of the 3774a second RF drive stage circuit. The other side of the secondary winding is coupled to the negative terminal of the 3774b second RF drive stage circuit. The positive output of the 3774a second RF drive stage circuit is coupled to the ultrasonic blade and the second negative ground terminal of the 3774b second RF drive stage circuit is coupled to an external tube. In one aspect, the transformer has an n1:n2 turns ratio of 1:50.

[0399] Figure 38 is a schematic diagram of a circuit 3800 comprising separate power supplies for high-power drive/power circuits and low-power circuits, in accordance with at least one aspect of the present description. The power supply 3812 includes a primary battery comprising first and second primary batteries 3815, 3817 (e.g., Li-ion batteries) that are connected to circuit 3800 by a switch 3818 and a secondary battery comprising a secondary battery 3820 that is connected to the circuit by a switch 3823 when the power supply 3812 is inserted into the battery pack. The 3820 secondary battery is a drop prevention battery that has components resistant to sterilization by gamma radiation or other radiation. For example, a switch mode power supply 3827 and an optional charging circuit within the battery pack may be incorporated to enable the secondary battery 3820 to reduce the voltage drop of the primary batteries 3815, 3817. This ensures cells fully loaded at the beginning of a surgery that are easy to introduce into the sterile field. Primary batteries 3815, 3817 can be used to power engine control circuits 3826 and power circuits 3832 directly. Motor control circuits 3826 are configured to control a motor, such as motor 3829. Power supply/battery 3812 may comprise a dual-type battery pack including primary Li-ion batteries 3815, 3817 and secondary NiMH batteries. 3820 with dedicated power cells 3820 to control the grip electronic circuits 3830 from the dedicated power cells 3815, 3817 to operate the motor control circuits 3826 and the power circuits 3832. In this case, the circuit 3810 is powered by the secondary batteries 3820 involved in driving the electronic circuits of the handle 3830 when the primary batteries 3815, 3817 involved in driving the power circuits 3832 and/or the engine control circuits 3826 are running low. In a different aspect, circuit 3810 may include a one-way diode that does not allow current to flow in the opposite direction (e.g., from the batteries involved in driving the power and/or motor control circuits to the batteries involved in in the activation of electronic circuits).

[0400] Additionally, a load circuit capable of exposure to gamma radiation may be provided including a switching mode power supply 3827 utilizing diodes and vacuum tube components to minimize voltage drop at a predetermined level. With the inclusion of a minimum voltage drop that is a division of the NiMH voltages (3 NiMH cells), the 3827 switching mode power supply could be eliminated. Furthermore, a modular system can be provided in which the radiation hardened components are situated in a module, making the module sterilizable by radiation sterilization. Other non-radiation hardened components may be included in other modular components and connections made between the modular components so that the component operates together as if the components were situated together on the same circuit board. If only two NiMH cells are desired, the 3827 switch-mode power supply based on diodes and vacuum tubes enables sterilizable electronic circuitry inside the disposable primary battery.

[0401] Referring now to Figure 39, there is shown a control circuit 3900 for operating a battery-powered RF generator circuit 3901 for use with a surgical instrument 3902, in accordance with one at least one aspect of the present description. The surgical instrument is configured to utilize both ultrasonic vibration and high frequency current to perform surgical coagulation/cutting treatments on living tissue, and utilizes high frequency current to perform surgical coagulation treatment on living tissue.

[0402] Figure 39 illustrates the control circuit 3900 that allows a dual generator system to switch between the power modalities of the RF generator circuit 3902 and the ultrasonic generator circuit 3920 for a surgical instrument of the surgical system 1000. In one aspect, a current threshold in an RF signal is detected. When the tissue impedance is low, the high frequency current through the tissue is high when RF energy is used as the source for tissue treatment. According to one aspect, a visual indicator 3912 or light situated on the surgical instrument of the surgical system 1000 may be configured to be in an on state during this high current period. When the current drops below a threshold, the 3912 visual indicator goes into an off state. Accordingly, a phototransistor 3914 can be configured to detect the transition from an on state to an off state and disable RF energy, as shown in the control circuit 3900 shown in Figure 39. Therefore, when the power button is released and a power switch 3926 is opened, control circuit 3900 is reset, and both RF and ultrasonic generator circuits 3902, 3920 are kept off.

[0403] Referring to Figure 39, in one aspect, a method of managing an RF generating circuit 3902 and an ultrasound generating circuit 3920 is provided. The RF generating circuit 3902 and/or the ultrasound generating circuit 3920 they may be located in the handle assembly 1109, the ultrasonic transducer/RF generator assembly 1120, the battery assembly, the drive shaft assembly 1129, and/or the nozzle of the multifunctional electrosurgical instrument 1108, for example. The control circuit 3900 is maintained in a reset state if the power switch 3926 is off (e.g., open). In this way, when the power switch 3926 is open, the control circuit 3900 is reset and both the RF and ultrasonic generating circuits 3902, 3920 are turned off. When the power switch 3926 is pressed and the power switch 3926 is engaged (e.g., closed), RF energy is distributed to the tissue and the visual indicator 3912 operated by a current sensing step-up transformer 3904 will be lit while tissue impedance is low. The 3912 visual indicator light provides a logic signal to maintain the 3920 ultrasonic generator circuit in the off state. Once the tissue impedance increases beyond a threshold and the high frequency current through the tissue decreases below a threshold, the 3912 visual indicator turns off and the light switches to an off state. A logic signal generated by this transition turns off relay 3908, whereby the RF generator circuit 3902 is turned off and the ultrasonic generator circuit 3920 is turned on, to complete the coagulation and cutting cycle.

[0404] Still referring to Figure 39, in one aspect, the dual generator circuit configuration uses the on-board RF generator circuit 3902, which is powered by battery 3901, for one embodiment, and a second ultrasound generator circuit. 3920 onboard, which may be included in the grip assembly 1109, the battery assembly, the drive shaft assembly 1129, the nozzle, and/or the ultrasonic transducer/RF generator assembly 1120 of the multifunctional circuit instrument 1108, for example. The ultrasonic generator circuit 3920 is also operated by battery 3901. In various aspects, the RF generator circuit 3902 and the ultrasonic generator circuit 3920 may be a component of the integrated or separable grip assembly 1109. In several respects, having the dual RF/ultrasonic generator circuits 3902, 3920 as part of the 1109 grip assembly can eliminate the need for complicated wiring. The RF/ultrasonic generator circuits 3902, 3920 can be configured to provide the full capabilities of an existing generator while simultaneously utilizing the capabilities of a wireless generator system.

[0405] Any type of system may have separate controls for modalities that are not communicating with each other. The surgeon activates RF and ultrasonic energy separately and at his or her discretion. Another approach would be to provide fully integrated communication schemes that share buttons, tissue states, instrument operating parameters (such as gripper closure system, forces, etc.), and algorithms to manage tissue treatment. Various combinations of this integration can be implemented to provide the appropriate level of function and performance.

[0406] As discussed above, in one aspect, control circuit 3900 includes an RF generator circuit 3902 powered by battery 3901 comprising a battery as a power source. As shown, the RF generating circuit 3902 is coupled to two electrically conductive surfaces herein called electrodes 3906a, 3906b (i.e., active electrode 3906a and return electrode 3906b) and is configured to drive electrodes 3906a, 3906b with RF energy. (e.g. high frequency current). A first winding 3910a of the step-up transformer 3904 is connected in series with a pole of the bipolar RF generator circuit 3902 and the return electrode 3906b. In one aspect, the first winding 3910a and the return electrode 3906b are connected to the negative pole of the bipolar RF generating circuit 3902. The other pole of the bipolar RF generating circuit 3902 is connected to the active electrode 3906a through a switch contact 3909 of relay 3908, or any suitable electromagnetic switching device comprising an armature that is moved by an electromagnet 3936 to operate the switch contact 3909. The switch contact 3909 is closed when the electromagnet 3936 is energized and the switch contact 3909 is opened when electromagnet 3936 is de-energized. When the switch contact is closed, RF current flows through the conductive fabric (not shown) situated between electrodes 3906a, 3906b. It will be recognized that, in one aspect, the active electrode 3906a is connected to the positive pole of the bipolar RF generator circuit 3902.

[0407] A visual indicator circuit 3905 comprises step-up transformer 3904, a series resistor R2, and a visual indicator 3912. Visual indicator 3912 may be adapted for use with surgical instrument 1108 and other electrosurgical systems and tools, such as those herein described. The first winding 3910a of the step-up transformer 3904 is connected in series to the return electrode 3906b and the second winding 3910b of the step-up transformer 3904 is connected in series to the resistor R2 and the visual indicator 3912 comprising a neon lamp of type NE-2 , for example.

[0408] In operation, when the switch contact 3909 of the relay 3908 is opened, the active electrode 3906a is disconnected from the positive pole of the bipolar RF generator circuit 3902 and no current flows through the tissue, the return electrode 3906b and the first winding 3910a of step-up transformer 3904. Consequently, visual indicator 3912 is not energized and does not emit light. When the switch contact 3909 of the relay 3908 is closed, the active electrode 3906a is connected to the positive pole of the bipolar RF generator circuit 3902, enabling current to flow through the tissue, the return electrode 3906b, and the first winding 3910a of the transformer lifting tool 3904 to work on the tissue, for example, cutting and cauterizing the tissue.

[0409] A first current flows through the first winding 3910a as a function of the impedance of the tissue located between the active and return electrodes 3906a, 3906b providing a first voltage through the first winding 3910a of the step-up transformer 3904. A second high voltage is induced through the second winding 3910b of the step-up transformer 3904. The secondary voltage appears across the resistor R2 and energizes the visual indicator 3912, causing the neon lamp to illuminate when the current through the tissue is higher than a predetermined threshold. It will be recognized that the circuit and component values are illustrative and not limited thereto. When switch contact 3909 of relay 3908 is closed, current flows through the fabric and visual indicator 3912 turns on.

[0410] Referring now to the power switch 3926 portion of the control circuit 3900, when the power switch 3926 is in the open position, a logic high is applied to the input of a first inverter 3928 and a logic low is applied to one of the two inputs of the AND gate 3932. Therefore, the output of the AND gate 3932 is low and a transistor 3934 is turned off to prevent current from flowing through the winding of the electromagnet 3936. With the electromagnet 3936 in the de-energized state, the contact switch 3909 of relay 3908 remains open and prevents current from flowing through electrodes 3906a, 3906b. The logic low output of the first 3928 inverter is also applied to a second 3930 inverter, causing the output to increase and resetting a 3918 flip-flop (e.g., a D-type flip-flop). At this time, the Q output goes low to turn off the ultrasound generator circuit 3920 and the Q output goes high and is applied to the other input of the AND gate 3932.

[0411] When the user presses the power switch 3926 on the instrument handle to apply energy to the tissue between electrodes 3906a, 3906b, the power switch 3926 closes and applies a logic low to the input of the first inverter 3928, which applies a logic high to the other input of AND gate 3932, causing the output of AND gate 3932 to increase and drive transistor 3934. In the on state, transistor 3934 conducts and reduces current through the winding of electromagnet 3936 to energize electromagnet 3936 and close switch contact 3909 of relay 3908. As discussed above, when switch contact 3909 is closed, current can flow through electrodes 3906a, 3906b and the first winding 3910a of step-up transformer 3904 when the fabric is situated between the electrodes 3906a, 3906b.

[0412] As discussed above, the magnitude of the current flowing through the electrodes 3906a, 3906b depends on the impedance of the tissue located between the electrodes 3906a, 3906b. Initially, the fabric impedance is low and the current magnitude is high through the fabric and the first winding 3910a. Consequently, the voltage applied to the second winding 3910b is high enough to turn on the visual indicator 3912. The light emitted by the visual indicator 3912 turns on the phototransistor 3914, which reduces the input of an inverter 3916 and causes the output of the inverter 3916 increase. A high input applied to the CLK of the 3918 flip-flop has no effect on the Q or the Q outputs of the 3918 flip-flop and the Q output remains high. Consequently, while the visual indicator 3912 remains energized, the ultrasound generating circuit 3920 is turned off and the ultrasonic transducer 3922 and an ultrasonic blade 3924 of the multifunctional electrosurgical instrument are not activated.

[0413] As the tissue between electrodes 3906a, 3906b dries due to the heat generated by the current flowing through the tissue, the impedance of the tissue increases and the current through it decreases. When the current through the first winding 3910a decreases, a voltage across the second winding 3910b also decreases and when a voltage drops below a minimum threshold required to operate the visual indicator 3912, the visual indicator 3912 and the phototransistor 3914 turn off. When the phototransistor 3914 turns off, a logic high is applied to the input of the inverter 3916 and a logic low is applied to the CLK input of the flip-flop 3918 to register a logic high to the Q output and a logic low to the Q output. output Q turns on the ultrasound generator circuit 3920 to activate the ultrasonic transducer 3922 and the ultrasonic blade 3924 to begin cutting the tissue located between the electrodes 3906a, 3906a. Simultaneously or almost simultaneously with the ultrasound generator circuit 3920 turning on, the Q output of the flip-flop 3918 goes to the logic low state and causes the output of the AND gate 3932 to go to the logic low state and turns off the transistor 3934, de-energizing thereby the electromagnet 3936 and opening the switch contact 3909 of the relay 3908 to cut off the flow of current through the electrodes 3906a, 3906b.

[0414] While the switch contact 3909 of the relay 3908 is open, no current flows through the electrodes 3906a, 3906b, the fabric and the first winding 3910a of the step-up transformer 3904. Therefore, no voltage is developed across the second winding 3910b and no current flows through visual indicator 3912.

[0415] The state of the Q and Q outputs of the flip-flop 3918 remains the same as long as the user presses the power switch 3926 on the instrument handle to keep the power switch 3926 closed. In this way, the ultrasonic blade 3924 remains activated and continues to cut the tissue between the end actuator jaws, while no current flows through the electrodes 3906a, 3906b from the bipolar RF generator circuit 3902. When the user releases the power switch, power 3926 on the instrument handle, the power switch 3926 opens and the output of the first inverter 3928 decreases and the output of the second inverter 3930 increases to reset the flip-flop 3918, causing the Q output to decrease and turn off the power generating circuit. ultrasound 3920. At the same time, the output Q increases and the circuit is now in an off state and ready for the user to operate the power switch 3926 on the instrument handle to close the power switch 3926, apply current to the tissue situated between electrodes 3906a, 3906b and repeat the cycle of applying RF energy to the tissue and ultrasonic energy to the tissue as described above.

[0416] Figure 40 illustrates a diagram of a surgical system 4000, which represents an aspect of the surgical system 1000, which comprises a feedback system for use with any of the Surgical Instruments of the surgical system 1000, which may include or implement many of the characteristics described in the present invention. The surgical system 4000 may include a generator 4002 coupled to a surgical instrument that includes an end actuator 4006, which may be activated when a physician operates a trigger 4010. In various aspects, the end actuator 4006 may include an ultrasonic blade to apply ultrasonic vibration to perform surgical coagulation/cutting treatments on living tissue. In other aspects, the end actuator 4006 may include electrically conductive elements coupled to a high-frequency electrosurgical current power source for performing surgical coagulation or cauterization treatments on living tissue and a mechanical knife with a sharp edge or an ultrasonic blade for perform cutting treatments on living tissue. When the trigger 4010 is actuated, a force sensor 4012 may generate a signal that indicates the amount of force that is applied to the trigger 4010. In addition to, or instead of, a force sensor 4012, the surgical instrument may include a sensor position 4013, which may generate a signal indicating the position of the trigger 4010 (e.g., how far the trigger has been pressed or otherwise actuated). In one aspect, the position sensor 4013 may be a sensor positioned with the outer tubular sheath or a reciprocating tubular actuation member situated within the outer tubular sheath of the surgical instrument. In one aspect, the sensor may be a Hall effect sensor or any suitable transducer that varies its output voltage in response to a magnetic field. The Hall effect sensor can be used for proximity switching, positioning, speed detection and current detection applications. In one aspect, the Hall effect sensor works like an analog transducer, directly returning a voltage. With a known magnetic field, its distance from the Hall plate can be determined.

[0417] A control circuit 4008 may receive signals from sensors 4012 and/or 4013. The control circuit 4008 may include any suitable analog or digital circuit components. The control circuit 4008 may also communicate with the generator 4002 and/or the transducer 4004 to modulate the power supplied to the end actuator 4006 and/or the generator level or the amplitude of the ultrasonic blade of the end actuator 4006 based on on the force applied to the trigger 4010 and/or the position of the trigger 4010 and/or the position of the outer tubular sheath described above relative to a reciprocating tubular actuation member situated within the outer tubular sheath (e.g., as measured by a combination Hall effect sensor and magnet). For example, the more force is applied to the trigger 4010, the more energy and/or greater ultrasonic blade amplitude can be supplied to the end actuator 4006. In various aspects, the force sensor 4012 can be replaced by a multiplex switch. positions.

[0418] In various aspects, the end actuator 4006 may include a claw or gripping mechanism. When trigger 4010 is initially pulled, the locking mechanism may close, trapping fabric between a gripping arm and end actuator 4006. As the force applied to the trigger increases (e.g., as detected by force sensor 4012), control circuit 4008 may increase the power supplied to end actuator 4006 by transducer 4004 and/or the generator level or ultrasonic blade amplitude generated at end actuator 4006. In one aspect, the position of the trigger, as detected by the position sensor 4013 or the position of the gripper or gripper arm as detected by the position sensor 4013 (e.g., with a Hall effect sensor) may be used by the control circuit 4008 to set the power and/or the amplitude of the end actuator 4006. For example, as the trigger is moved further toward a fully actuated position, or the gripper or gripper arm moves further toward the ultrasonic blade (or end actuator 4006), the energy and/or the amplitude of the end actuator 4006 can be increased.

[0419] In various aspects, the surgical instrument of the surgical system 4000 may also include one or more feedback devices to indicate the amount of power supplied to the end actuator 4006. For example, a speaker 4014 may output a signal indicative of the power of the end actuator. According to various aspects, the speaker 4014 can emit a series of pulse sounds, where the frequency of the sounds indicates the power. In addition to or instead of the speaker 4014, the surgical instrument may include a visual display 4016. The visual display 4016 may indicate the end actuator in accordance with any suitable method. For example, visual display 4016 may include an array of LEDs, wherein end actuator power is indicated by the number of illuminated LEDs. Speaker 4014 and/or visual display 4016 may be driven by control circuit 4008. In various aspects, the surgical instrument may include a ratchet device connected to trigger 4010. The ratchet device may generate an audible signal the more force is applied to the trigger 4010, providing an indirect indication of end actuator power. The surgical instrument may include other features that may increase safety. For example, the control circuit 4008 may be configured to prevent power from being supplied to the end actuator 4006 beyond a predetermined limit. Additionally, control circuit 4008 may implement a delay between the time that a change in end actuator power is indicated (e.g., by speaker 4014 or visual display 4016) and the time that the change in power is indicated. of end actuator is provided. This way, a clinician can be well aware that the level of ultrasonic energy that must be delivered to the 4006 tip actuator is about to change.

[0420] In one aspect, the ultrasonic or high-frequency current generators of the surgical system 1000 may be configured to digitally generate the electrical signal waveform in the desired manner using a predetermined number of phase points stored in a look-up table, scan the waveform. The phase points can be stored in a defined table in a memory, a field programmable gate array (FPGA), or any suitable non-volatile memory. Figure 41 illustrates one aspect of a fundamental architecture for a digital synthesis circuit, such as a digital direct synthesis (DDS) circuit 4100, configured to generate a plurality of waveforms for the electrical signal waveform. Generator software and digital controls may command the FPGA to scan addresses in lookup table 4104, which in turn provides variable digital input values to a DAC circuit 4108 that feeds a power amplifier. Addresses can be scanned according to a frequency of interest. The use of such a look-up table 4104 makes it possible to generate various types of waveforms that can be fed into the tissue or into a transducer, an RF electrode, multiple transducers simultaneously, or a combination of ultrasonic and RF instruments. Additionally, multiple lookup tables 4104 representing multiple waveforms can be created, stored, and applied to tissue from one generator.

[0421] The signal waveform may be configured to control at least one of an output current, an output voltage, or an output power of an ultrasonic transducer and/or RF electrode, or multiples thereof (e.g. , two or more ultrasonic transducers and/or two or more RF electrodes). Furthermore, where a surgical instrument comprises ultrasonic components, the waveform may be configured to drive at least two vibration modes of an ultrasonic transducer of at least one surgical instrument. In this way, the generator may be configured to provide a waveform to at least one surgical instrument, wherein the waveform signal corresponds to at least one waveform of a plurality of waveforms in the table. Furthermore, the waveform signal provided to the two surgical instruments may comprise two or more waveforms. The table may comprise information associated with a plurality of waveforms and the table may be stored within the generator. In one aspect or example, the table may be a digital direct synthesis table, which may be stored in an FPGA of the generator. The table can be addressed in any way that is convenient for categorizing waveforms. According to one aspect, the table, which may be a digital direct synthesis table, is addressed according to a frequency of the waveform signal. Furthermore, information associated with the plurality of waveforms can be stored as digital information in the table.

[0422] The analog electrical signal waveform may be configured to control at least one of an output current, an output voltage, or an output power of an ultrasonic transducer and/or RF electrode, or multiples thereof ( e.g., two or more ultrasonic transducers and/or two or more RF electrodes). Furthermore, where the surgical instrument comprises ultrasonic components, the analog electrical signal waveform may be configured to drive at least two vibration modes of an ultrasonic transducer of at least one surgical instrument. In this way, the generator circuit may be configured to provide an analog electrical signal waveform to at least one surgical instrument, wherein the analog electrical signal waveform corresponds to at least one waveform of a plurality of surgical instrument waveforms. waveform stored in lookup table 4104. Furthermore, the analog electrical signal waveform provided to the at least two surgical instruments may comprise two or more waveforms. The look-up table 4104 may comprise information associated with a plurality of waveforms and the look-up table 4104 may be stored within the generating circuit or surgical instrument. In one aspect or example, the lookup table 4104 may be a digital direct synthesis table, which may be stored in an FPGA of the generator circuit or surgical instrument. The lookup table 4104 can be addressed in any way that is convenient for categorizing the waveforms. In one aspect, the lookup table 4104, which may be a digital direct synthesis table, is addressed according to a frequency of the desired analog electrical signal waveform. Furthermore, information associated with the plurality of waveforms may be stored as digital information in lookup table 4104.

[0423] With the widespread use of digital techniques in instrumentation and communications systems, a digitally controlled method of generating multiple frequencies from a reference frequency source has evolved and is referred to as direct digital synthesis. The basic architecture is shown in Figure 41. In this simplified block diagram, a DDS circuit is coupled to a processor, controller, or logic device in the generator circuit and to a memory circuit located in the generator circuit of the surgical system 1000. The DDS circuit 4100 comprises an address counter 4102, a lookup table 4104, a register 4106, an A-D converter circuit 4108, and a filter 4112. A stable clock fc is received by the address counter 4102, and the register 4106 drives a programmable read-only memory ( PROM) that stores one or more integer cycles of a sine wave (or other arbitrary waveform) in a lookup table 4104. As the address counter 4102 cycles through memory locations, the values stored in the lookup table query 4104 are written to register 4106, which is coupled to DAC circuit 4108. The corresponding digital amplitude of the signal in the memory location of lookup table 4104 drives the A-D converter circuit 4108, which in turn generates an analog output signal 4110. The spectral purity of the analog output signal 4110 is mainly determined by the A-D converter circuit 4108. The phase noise is basically that of the reference clock fc. The first analog output signal 4110 from the A-D converter circuit 4108 is filtered by the filter 4112 and a second analog output signal 4114 produced by the filter 4112 is provided to an amplifier having an output coupled to the output of the generator circuit. The second analog output signal has a frequency fout.

[0424] As the DDS 4100 circuit is a sampled data system, problems involved in sampling need to be considered: quantization noise, distortion, filtering, etc. For example, the higher-order harmonics of the output frequencies of the 4108 DAC circuit fold into the Nyquist bandwidth, making them unfilterable, whereas the higher-order harmonics of the output of DAC circuit-based synthesizers phase-locked loop or phase-locked loop (PLL) can be filtered. Lookup table 4104 contains signal data for an integral number of cycles. The final output frequency foutput can be changed by changing the reference clock frequency fc or by reprogramming the PROM.

[0425] The DDS circuit 4100 may comprise multiple lookup tables 4104, wherein the lookup table 4104 stores a waveform represented by a predetermined number of samples, wherein the samples define a predetermined shape of the waveform. In this way, multiple waveforms, having a unique shape, can be stored in multiple lookup tables 4104 to provide different tissue treatments based on instrument settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveforms for deeper tissue penetration, and signal waveforms. electric that promote efficient touch-up coagulation. In one aspect, the DDS circuit 4100 may create multiple waveform lookup tables 4104 and during a tissue treatment procedure (e.g., simultaneously or in virtual real time based on user or sensor inputs) switch between different waveforms. of waves stored in separate lookup tables 4104 based on the desired tissue effect and/or tissue feedback.

[0426] Therefore, switching between waveforms can be based on tissue impedance and other factors, for example. In other aspects, lookup tables 4104 can store electrical signal waveforms formatted to maximize the power delivered to the tissue per cycle (i.e., trapezoidal or square wave). In other aspects, lookup tables 4104 can store synchronized waveforms such that they maximize power delivery by the multifunctional surgical instrument of surgical system 1000 when it provides RF and ultrasonic drive signals. In still other aspects, lookup tables 4104 can store electrical signal waveforms to simultaneously drive therapeutic and/or subtherapeutic ultrasonic and RF energy while simultaneously maintaining ultrasonic frequency lock. Custom waveforms specific to different instruments and their tissue effects can be stored in the non-volatile memory of the generator or the non-volatile memory (e.g., EEPROM) of the surgical system 1000 and fetched when connecting the multifunctional surgical instrument to the generator circuit. An example of an exponentially damped sinusoid, as used in many high crest factor "coagulation" waveforms, is shown in Figure 43.

[0427] A more flexible and efficient implementation of the DDS 4100 circuit uses a digital circuit called a Numerically Controlled Oscillator (NCO). A block diagram of a more flexible and efficient digital synthesis circuit, such as a DDS 4200 circuit, is shown in Figure 42. In this simplified block diagram, a DDS 4200 circuit is coupled to a processor, controller, or generator logic device and to a memory circuit located in the generator or any of the surgical instruments of the surgical system 1000. The DDS circuit 4200 comprises a charge register 4202, a parallel delta phase register 4204, an adder circuit 4216, a phase register 4208, a lookup table 4210 (phase-to-amplitude converter), an A-D converter circuit 4212 and a filter 4214. The adder circuit 4216 and the phase register 4208 form part of a phase accumulator 4206. A clock signal fc is applied to the phase register phase 4208 and to a DAC circuit 4212. The load register 4202 receives a tuning word that specifies the output frequency as a fraction of the reference clock frequency signal fc. The output of the load register 4202 is fed to the parallel delta phase register 4204 with an M tuning word.

[0428] The DDS circuit 4200 includes a sample clock that generates the clock frequency fc, the phase accumulator 4206, and the look-up table 4210 (e.g., phase-to-amplitude converter). The contents of the phase accumulator 4206 are updated once per fc clock cycle. When the phase accumulator 4206 is updated, the digital number, M, stored in the delta phase register 4204 is added to the number in the phase register 4208 by an adder circuit 4216. Assuming that the number in the parallel delta phase register 4204 is 00 ...01 and that the initial content of the phase accumulator 4206 is 00...00. The 4206 phase accumulator is updated by 00...01 per clock cycle. If the 4206 phase accumulator has a width of 32 bits, it takes 232 clock cycles (more than 4 billion) before the 4206 phase accumulator returns to 00...00, and the cycle repeats.

[0429] A truncated output 4218 of the phase accumulator 4206 is provided to a look-up table of the phase-to-amplitude converter 4210 and the output of the look-up table 4210 is coupled to a DAC circuit 4212. The truncated output 4218 of the phase accumulator 4206 serves as the address for a sine (or cosine) lookup table. An address in the lookup table corresponds to a phase point in the sine wave from 0° to 360°. The lookup table 4210 contains digital amplitude information corresponding to one complete cycle of a sine wave. The look-up table 4210 therefore maps the phase information from the phase accumulator 4206 into a digital amplitude word, which in turn drives the A-D converter circuit 4212. The output of the A-D converter circuit is a first analog signal 4220 and is filtered by a filter 4214. The output of the filter 4214 is a second analog signal 4222, which is supplied to a power amplifier coupled to the generator circuit.

[0430] In one aspect, the electrical signal waveform can be digitized at 1024 (210) phase points, although the waveform that can be digitized is any suitable number of 2n phase points ranging from 256 (28) to 281,474,976,710,656 (248), where n is a positive integer as shown in TABLE 1. The electrical signal waveform can be expressed as An (θn), where a normalized amplitude An at a point n is represented by a phase angle θn is called the phase point at point n. The number of discrete phase points n determines the tuning resolution of the DDS 4200 circuit (as well as the DDS 4100 circuit shown in Figure 41).

[0431] Table 1 specifies the electrical signal waveform digitized at a number of phase points. Table 1

[0432] The generator circuit algorithms and digital controls may scan addresses in the lookup table 4210, which in return provides variable digital input values to the DAC circuit 4212 that feeds the filter 4214 and the power amplifier. Addresses can be scanned according to a frequency of interest. The use of the look-up table allows the generation of various types of formats that can be converted into an analog output signal by the A-D converter circuit 4212 filtered by the filter 4214, amplified by the power amplifier coupled to the output of the generator circuit and fed to the tissue under the form of RF energy or fed to a transducer and applied to tissue in the form of ultrasonic vibrations that deliver energy to the tissue in the form of heat. The amplifier output can be applied to an RF electrode, multiple output electrodes simultaneously, an ultrasonic transducer, multiple ultrasonic transducers simultaneously, or a combination of RF and ultrasonic transducers, for example. Additionally, multiple waveform tables can be created, stored, and applied to tissue from one generator circuit.

[0433] Referring back to Figure 41, for n = 32 and M = 1, phase accumulator 4206 scales each of the 232 possible outputs before overflowing and resetting. The corresponding output wave frequency is equal to the input clock frequency divided by 232. If M = 2, then the 1708 phase register "runs" twice as fast, and the output frequency is doubled. This can be generalized as follows.

[0434] For a 4206 phase accumulator configured to accumulate n-bits (generally in the range of 24 to 32 in most DDS systems, but as previously discussed, n can be selected from a wide range of options), there are 2n possible phase points. The digital word in the delta M phase register represents the amount of phase accumulation that is incremented per clock cycle. If fc is the clock frequency, then the frequency of the output sine wave is equal to:

[0435] The above equation is known as the DDS "tuning equation". It is observed that the frequency resolution of the system is equal to . For n = 32, the resolution is greater than one part in four billion. In one aspect of the DDS system 4200, not all bits outside the phase accumulator 4206 pass into the lookup table 4210, but are truncated, leaving only the first 13 to 15 most significant bits (MSBs), for example. This reduces the size of the 4210 lookup table and does not affect frequency resolution. Phase truncation only adds a small but acceptable amount of phase noise to the final output.

[0436] The electrical signal waveform can be characterized by current, voltage or power at a certain frequency. Furthermore, when any of the surgical instruments of the surgical system 1000 comprises ultrasonic components, the electrical signal waveform may be configured to drive at least two vibration modes of an ultrasonic transducer of at least one surgical instrument. In this way, the generator circuit may be configured to provide an electrical signal waveform to at least one surgical instrument, wherein the electrical signal waveform is characterized by a predetermined waveform stored in lookup table 4210 (or lookup table 4104, Figure 41). Furthermore, the electrical signal waveform may be a combination of two or more waveforms. The lookup table 4210 may comprise information associated with a plurality of waveforms. In one aspect or example, the lookup table 4210 may be generated by the DDS circuit 4200 and may be called a digital direct synthesis table. Direct digital synthesis (DDS) operates by first storing a large repetitive waveform in onboard memory. One cycle of a waveform (sine, triangular, square, arbitrary) can be represented by a predetermined number of phase points as shown in TABLE 1 and stored in memory. Once the waveform is stored in memory, it can be generated at very precise frequencies. The digital direct synthesis table may be stored in a non-volatile memory of the generator circuit and/or may be implemented with an FPGA circuit in the generator circuit. The lookup table 4210 may be addressed by any suitable technique that is convenient for categorizing the waveforms. In one aspect, the lookup table 4210 is addressed according to a frequency of the electrical signal waveform. Furthermore, information associated with the plurality of waveforms may be stored as digital information in a memory or as part of the lookup table 4210.

[0437] In one aspect, the generator circuit may be configured to provide electrical signal waveforms to at least two surgical instruments simultaneously. The generator circuit may also be configured to provide the electrical signal waveform, which may be characterized by two or more waveforms, through an output channel of the generator circuit to the two surgical instruments simultaneously. For example, in one aspect, the electrical signal waveform comprises a first electrical signal for driving an ultrasonic transducer (e.g., ultrasonic drive signal), a second RF drive signal, and/or a combination thereof. Furthermore, an electrical signal waveform may comprise a plurality of ultrasonic drive signals, a plurality of RF drive signals, and/or a combination of a plurality of ultrasonic and RF drive signals.

[0438] Furthermore, a method for operating the generator in accordance with the present disclosure comprises generating an electrical signal waveform and providing the generated electrical signal waveform to any of the surgical instruments of the surgical system 1000, wherein generating the electrical signal waveform comprises receiving information associated with the electrical signal waveform from a memory. The generated electrical signal waveform comprises at least one waveform. Further, providing the generated electrical signal waveform to at least one surgical instrument comprises providing the electrical signal waveform to at least two surgical instruments simultaneously.

[0439] The generator circuit, as described herein, may allow the generation of various types of digital direct synthesis tables. Examples of waveforms for RF/electrosurgical signals suitable for treating a variety of tissues generated by the generator circuit include RF signals with a high crest factor (which can be used for superficial coagulation in RF mode), high crest factor RF signals low crest (which can be used for deeper tissue penetration) and touch-up waveforms that promote efficient coagulation. The generator circuit can also generate multiple waveforms employing a 4210 digital direct synthesis lookup table and, in real time, can switch between specific waveforms based on the desired tissue effect. Alternation may be based on tissue impedance and/or other factors.

[0440] In addition to traditional sine/cosine waveforms, the generator circuit can be configured to generate waveform(s) that maximize tissue power per cycle (e.g., trapezoidal or square wave). The generator circuit may provide waveforms that are synchronized to maximize the power delivered to the load by simultaneously driving RF and ultrasonic signals and maintaining ultrasonic frequency lock, provided that the generator circuit includes a circuit topology that enables simultaneous driving of RF and ultrasonic signals. Additionally, instrument-specific custom waveforms and their effects on tissue can be stored in a non-volatile memory (NVM) or an instrument EEPROM and can be fetched by connecting any of the surgical instruments of the surgical system 1000 to the generator circuit.

[0441] The DDS circuit 4200 may comprise multiple look-up tables 4104, where the look-up table 4210 stores a waveform represented by a predetermined number of phase points (also called samples), wherein the phase points define a predetermined waveform format. In this way, multiple waveforms, having a unique shape, can be stored in multiple lookup tables 4210 to provide different tissue treatments based on instrument settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveforms for deeper tissue penetration, and signal waveforms. electric that promote efficient touch-up coagulation. In one aspect, the DDS circuit 4200 may create multiple waveform lookup tables 4210 and during a tissue treatment procedure (e.g., simultaneously or in virtual real time based on user or sensor inputs) switch between different formats. waveforms stored in different lookup tables 4210 based on the effect on the desired tissue and/or tissue feedback.

[0442] Therefore, switching between waveforms can be based on tissue impedance and other factors, for example. In other aspects, the lookup tables 4210 can store electrical signal waveforms formatted to maximize the power delivered to the tissue per cycle (i.e., trapezoidal or square wave). In other aspects, the lookup tables 4210 can store synchronized waveforms such that they maximize power delivery by any of the surgical instruments of the surgical system 1000 when it provides RF and ultrasonic drive signals. In still other aspects, lookup tables 4210 can store electrical signal waveforms to simultaneously drive therapeutic and/or subtherapeutic ultrasonic and RF energy while simultaneously maintaining ultrasonic frequency lock. Generally speaking, the output waveform can be in the form of a sine wave, cosine wave, pulse wave, square wave and the like. However, more complex custom waveforms specific to different instruments and their tissue effects can be stored in the non-volatile memory of the generator circuit or in the non-volatile memory (e.g., EEPROM) of the surgical instrument and fetched when connecting the surgical instrument. in the generator circuit. An example of a custom waveform is an exponentially damped sine wave as used in many high crest factor "coagulation" waveforms, as shown in Figure 43.

[0443] Figure 43 illustrates a cycle of a discrete-time digital electrical signal waveform 4300, in accordance with at least one aspect of the present description, of an analog waveform 4304 (shown superimposed on the waveform of the isolated digital electrical time signal 4300 for comparison purposes). The horizontal geometric axis represents Time (t) and the vertical geometric axis represents the digital phase points. The digital electrical signal waveform 4300 is an isolated digital time version of the desired analog waveform 4304, for example. The waveform of the digital electrical signal 4300 is generated by storing an amplitude phase point 4302 representing the amplitude per clock cycle Tclk over a cycle or period To. The digital electrical signal waveform 4300 is generated over a period To by any suitable digital processing circuit. Amplitude phase points are digital words stored in a memory circuit. In the example illustrated in Figures 41 and 42, the digital word is a 6-bit word that is capable of storing amplitude phase points with a resolution of 26 or 64 bits. It will be recognized that the examples shown in Figures 41 and 42 are for illustrative purposes and in actual implementations the resolution may be much higher. Digital amplitude phase points 4302 during a To cycle are stored in memory as a string of the word string in a look-up table 4104, 4210, as described with respect to Figures 41 and 42, for example. To generate the analog version of the analog waveform 4304, the amplitude phase points 4302 are read sequentially from memory from 0 to To per Tclk clock cycle and are converted by an A-D converter circuit 4108, 4212, also described in 41 and 42. Additional cycles may be generated by repeatedly reading the amplitude phase points 4302 of the digital electrical signal waveform 4300 from 0 to To for as many cycles or periods as may be desired. The smooth analog version of the 4304 waveform is achieved by filtering the output of the A-D converter circuit 4108, 4212 by a filter 4112, 4214 (Figures 41 and 42). The filtered analog output signal 4114, 4222 (Figures 41 and 42) is applied to the input of a power amplifier.

[0444] Figure 44 is a diagram of a control system 12950 configured to provide progressive closure of a closure member (e.g., closure tube) when the travel member advances distally and engages a clamping arm (e.g., example, anvil) to decrease the closing force load on the closing member at a desired speed and decrease the firing force load on the firing member in accordance with an aspect of the present description. In one aspect, the 12950 control system can be implemented as a nested PID feedback controller. A PID controller is a control loop (controller) feedback mechanism to continuously calculate an error value as the difference between a desired set point and a measured process variable and apply a correction based on proportional, integral, and derivative terms (sometimes indicated P, I, and D respectively). The feedback control system of the nested PID controller 12950 includes a primary controller 12952, in a primary (external) feedback circuit 12954 and a secondary controller 12955 in a secondary (internal) feedback circuit 12956. The primary controller 12952 may be a PID controller 12972 as shown in Figure 45, and the secondary controller 12955 may also be a PID controller 12972 as shown in Figure 45. The primary controller 12952 controls a primary process 12958 and the secondary controller 12955 controls a secondary process 12960. The output 12966 of the primary processor 12958 is subtracted from a primary set point P 1 by a first adder 12962. The first adder 12962 produces a single output sum signal that is applied to the primary controller 12952. The output of the primary controller 12952 is the point SP2 secondary adjustment. The output 12968 of the secondary processor 12960 is subtracted from a primary set point SP2 by a first adder 12964.

[0445] In the context of controlling the displacement of a closure tube, the control system 12950 may be configured such that the primary set point SP1 is a desired closure force value and the primary controller 12952 is configured to receive the closing force from a torque sensor coupled to the output of a closing motor and determine a motor speed from setpoint SP2 for the closing motor. In other aspects, the closing force can be measured with strain gauges, load cells, or other suitable force sensors. The SP2 closure motor speed set point is compared to the actual speed of the closure tube, which is determined by the 12955 secondary controller. The actual speed of the closure tube can be measured by comparing the displacement of the closure tube with the sensor position and measuring the elapsed time with a timer/counter. Other techniques such as linear or rotary encoders can be used to measure closure tube displacement. The output 12968 of the secondary process 12960 is the actual speed of the shut-off tube. This closure tube speed output 12968 is provided to the primary processor 12958 which determines the force acting on the closure tube and is fed back to the adder 12962 which subtracts the measured clamping force from the primary set point SP1. The SP1 master setpoint can be an upper threshold or a lower threshold. Based on the output of the adder 12962, the primary controller 12952 controls the speed and direction of the closing motor. The secondary controller 12955 controls the closure motor speed based on the actual closure tube speed measured by the secondary process 12960 and the secondary setpoint SP2, which is based on a comparison of the upper and lower trigger force thresholds and of the actual firing force.

[0446] Figure 45 illustrates a PID feedback control system 12970, in accordance with an aspect of the present description. The primary controller 12952 or the secondary controller 12955, or both, may be implemented as a PID controller 12972. In one aspect, the PID controller 12972 may comprise a proportional element 12974 (P), an integral element 12976 (I), and a derivative element 12978 (D). The outputs of the P, I and D elements 12974, 12976, 12978 are summed by an adder 12986, which provides the control variable μ(t) to the process 12980. The output of the process 12980 is the process variable y(t). An adder 12984 calculates the difference between a desired set point r(t) and a measured process variable y(t). The 12972 PID controller continuously calculates an error value e(t) (e.g., the difference between the closing force threshold and the measured closing force) as the difference between a desired set point r(t) (e.g. , the closing force threshold) and the measured process variable y(t) (for example, the speed and direction of the closing tube) and applies a correction based on the proportional, integral and derivative terms calculated by the proportional element 12974 ( P), the integral element 12976 (I), and the derivative element 12978 (D), respectively. The 12972 PID controller attempts to minimize the error e(t) over time by adjusting the control variable μ(t) (for example, the speed and direction of the shutoff tube).

[0447] According to the PID algorithm, the "P" element 12974 represents the present values of the error. For example, if the error is large and positive, the control output will also be large and positive. According to the present description, the error term e(t) is the difference between the desired closing force and the measured closing force of the closing tube. The "I" element 12976 represents the past values of the error. For example, if the current output is not strong enough, the error integral will accumulate over time, and the controller will respond by applying a stronger action. The "D" element 12978 represents possible future trends of the error, based on its actual rate of change. For example, continuing example P above, when the large positive control output manages to bring the error closer to zero, it also puts the process into a large negative error mode in the near future. In this case, the derivative becomes negative and module D reduces the strength of the action to avoid this excess.

[0448] It will be understood that other variables and set points can be monitored and controlled in accordance with the feedback control systems 12950, 12970. For example, the adaptive closure member speed control algorithm described herein can mediate the least two of the following parameters: the location of travel of the firing member, the load of the firing member, the displacement of the cutting element, the speed of the cutting element, the location of travel of the shut-off tube, the load of the closure, among others.

[0449] Ultrasonic surgical devices, such as ultrasonic scalpels, are finding increasingly widespread applications in surgical procedures, due to their unique performance characteristics. Depending on specific device configurations and operating parameters, ultrasonic surgical devices can provide substantially simultaneous tissue transection and coagulation homeostasis, desirably minimizing patient trauma. An ultrasonic surgical device may comprise a handle containing an ultrasonic transducer, and an instrument coupled to the ultrasonic transducer having a distally mounted end actuator (e.g., a blade tip) for cutting and sealing tissue. In some cases, the instrument may be permanently attached to the handpiece. In other cases, the instrument may be separable from the handle, as in the case of a disposable instrument or an interchangeable instrument. The end actuator transmits ultrasonic energy to the tissues placed in contact with it, to perform the cutting and cauterization action. Ultrasonic surgical devices of this nature can be configured for use in open, laparoscopic or endoscopic surgical procedures, including robotically assisted procedures.

[0450] Ultrasonic energy cuts and coagulates tissue using temperatures lower than those used in electrosurgical procedures and can be transmitted to the end actuator by an ultrasonic generator in communication with the handle. Vibrating at high frequencies (e.g. 55,500 cycles per second), the ultrasonic blade denatures protein present in tissues to form a sticky clot. The pressure exerted on the tissues by the surface of the blade flattens the blood vessels and allows the clot to form a hemostatic seal. A surgeon can control the speed of cutting and coagulation through the force applied to tissues by the end actuator, the time for which the force is applied, and the excursion level selected for the end actuator.

[0451] The ultrasonic transducer can be modeled as an equivalent circuit comprising a first branch that has a static capacitance and a second "moving" branch that has a series-connected inductance, resistance and capacitance that define the electromechanical properties of a resonator . Known ultrasonic generators may include a tuning inductor to cancel static capacitance at a resonant frequency so that substantially all of the generator drive signal current flows to the moving branch. Consequently, through the use of a tuning inductor, the generator drive signal current represents the moving branch current, and the generator is thus able to control its drive signal to maintain the resonant frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance plot of the ultrasonic transducer to optimize the frequency locking capabilities of the generator. However, the tuning inductor needs to be matched to the specific static capacitance of an ultrasonic transducer at the operating resonance frequency. In other words, a different ultrasonic transducer having a different static capacitance needs a tuning inductor.

[0452] Additionally, in some ultrasonic generator architectures, the generator drive signal exhibits asymmetric harmonic distortion that complicates impedance magnitude and phase measurements. For example, the accuracy of impedance phase measurements may be reduced due to harmonic distortion in current and voltage signals.

[0453] Additionally, electromagnetic interference in noisy environments decreases the generator's ability to maintain locking at the resonant frequency of the ultrasonic transducer, increasing the likelihood of invalid control algorithm inputs.

[0454] Electrosurgical devices for applying electrical energy to tissues in order to treat and/or destroy said tissues are also finding increasingly widespread applications in surgical procedures. An electrosurgical device may comprise a handle and an instrument having a distally mounted end actuator (e.g., one or more electrodes). The end actuator can be positioned against the tissue so that the electrical current is introduced into the tissue. Electrosurgical devices can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into the tissue and returned from it by the active and return electrodes, respectively, of the end actuator. During monopolar operation, a current is introduced into the tissue by an active electrode of the tip actuator and returned through a return electrode (e.g., a grounding plate) separately located on the patient's body. The heat generated by the current flowing through the tissue can form hemostatic seals within the tissue and/or between tissues and thus can be particularly useful for cauterizing blood vessels, for example. The end actuator of an electrosurgical device may also comprise a cutting member that is capable of moving relative to the tissue and electrodes to transect the tissue.

[0455] Electrical energy applied by an electrosurgical device can be transmitted to the instrument by a generator in communication with the handle. Electrical energy can be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 300 kHz to 1 MHz, as described in EN60601-2-2:2009+A11:2011, Definition 201.3.218 - HIGH FREQUENCY. For example, the frequency in monopolar RF applications can typically be restricted to less than 5 MHz. However, in bipolar RF applications, the frequency can be almost any. Frequencies above 200 kHz are typically used for monopolar applications to avoid unwanted nerve and muscle stimulation that would result from using a low frequency current. Lower frequencies may be used for bipolar techniques if a risk analysis shows that the possibility of neuromuscular stimulation has been mitigated to an acceptable level. Typically, frequencies above 5 MHz are not used in order to minimize problems associated with high-frequency stray currents. It is generally accepted that 10 mA is the lower threshold for thermal effects on tissue.

[0456] During this operation, an electrosurgical device can transmit low frequency RF energy through the tissue, which causes friction, or ionic agitation, i.e., resistive heating, which therefore increases the temperature of the tissue. Because a precise boundary can be created between the affected tissue and surrounding tissue, surgeons can operate with a high level of precision and control without sacrificing adjacent non-target tissue. The low operating temperatures of RF energy can be useful for removing, shrinking, or sculpting soft tissue while simultaneously cauterizing blood vessels. RF energy can work particularly well on connective tissue, which primarily comprises collagen and shrinks when it comes into contact with heat.

[0457] Due to their unique drive signal, detection, and feedback needs, ultrasonic and electrosurgical devices often require different generators. Furthermore, in cases where the instrument is disposable or interchangeable with a handle, ultrasonic and electrosurgical generators are limited in their ability to recognize the configuration of the specific instrument being used and to optimize control and diagnostic processes accordingly. Additionally, capacitive coupling between non-isolated patient and isolated generator circuits, especially in cases where higher voltages and frequencies are used, may result in exposing a patient to unacceptable levels of leakage current.

[0458] Furthermore, due to their unique drive signal, sensing, and feedback needs, ultrasonic and electrosurgical devices often require different user interfaces for the different generators. In such conventional ultrasonic and electrosurgical devices, one user interface is configured for use with an ultrasonic instrument whereas a different user interface may be configured for use with an electrosurgical instrument. Such user interfaces include hand- and/or foot-activated user interfaces, such as hand-activated switches and/or foot-activated switches. When various aspects of combined generators for use with both ultrasonic instruments and electrosurgical instruments are contemplated in the subsequent description, additional user interfaces that are configured to operate with both ultrasonic and electrosurgical instrument generators are also contemplated.

[0459] Additional user interfaces for providing feedback, whether to the user or to another machine, are contemplated in the subsequent description to provide feedback that indicates a mode of operation or status of an ultrasonic and/or electrosurgical instrument. Providing user and/or machine feedback to operate an ultrasonic and/or electrosurgical instrument in combination will require providing sensory feedback to a user and electrical/mechanical/electromechanical feedback to a machine. Feedback devices that incorporate visual feedback devices (e.g., an LCD display screen, LED indicators), audio feedback devices (e.g., a speaker, a buzzer), or tactile feedback devices (e.g., example, haptic actuators) for use in combined ultrasonic and/or electrosurgical instruments are contemplated in the subsequent description.

[0460] Other electrical surgical instruments include, without limitation, irreversible and/or reversible electroporation, and/or microwave technologies, among others. Consequently, the techniques described here are applicable to ultrasonic, bipolar or monopolar RF (electrosurgical), irreversible and/or reversible electroporation and/or microwave-based surgical instruments, among others.

[0461] Various aspects are directed to improved ultrasonic surgical devices, electrosurgical devices, and generators for use therewith. Aspects of ultrasonic surgical devices can be configured to transect and/or coagulate tissue during surgical procedures, for example. Aspects of electrosurgical devices can be configured to transect, coagulate, scale, weld, and/or desiccate tissue during surgical procedures, for example.

[0462] The generator aspects utilize high-speed analog-to-digital sampling (e.g., approximately 200 x oversampling, depending on frequency) of the current and voltage of the generator drive signal, along with digital signal processing, to provide numerous advantages and benefits over known generator architectures. In one aspect, for example, based on current and voltage feedback data, a value of the static capacitance of the ultrasonic transducer, and a value of the frequency of the drive signal, the generator can determine the current of the moving branch of a transducer. ultrasonic. This provides the benefit of a virtually tuned system, and simulates the presence of a system that is tuned or resonant with any value of static capacitance (e.g., C0 in Figure 25) at any frequency. Consequently, control of the motion branch current can be accomplished by canceling the effects of static capacitance without the need for a tuning inductor. Furthermore, elimination of the tuning inductor cannot degrade the frequency locking capabilities of the generator, as frequency locking can be accomplished by properly processing the current and voltage feedback data.

[0463] High-speed analog-to-digital sampling of the current and voltage of the generator drive signal, together with digital signal processing, can also enable accurate digital filtering of samples. For example, aspects of the generator may utilize a digital low-pass filter (e.g., a finite impulse response (FIR) filter that rolls off between a fundamental drive signal frequency and a second-order harmonic to reduce asymmetric harmonic distortion and EMI-induced noise in the current and voltage feedback samples. The filtered current and voltage feedback samples substantially represent the frequency of the fundamental drive signal, thus allowing a more accurate measurement of the impedance phase relative to the signal frequency. of fundamental drive and an improvement in the generator's ability to maintain resonant frequency lock. The accuracy of the impedance phase measurement can be further optimized by averaging the falling edge and falling edge measurements, and by tuning. of the impedance phase measured at 0°.

[0464] Various aspects of the generator may also utilize high-speed analog-to-digital sampling of the current and voltage of the generator drive signal, along with digital signal processing, to determine actual power consumption and other quantities with a high degree of precision. This can allow the generator to implement a number of useful algorithms, such as controlling the amount of power applied to the tissue as the tissue impedance changes, and controlling the application of power to maintain a constant rate of increase in tissue impedance. Some of these algorithms are used to determine the phase difference between the current and voltage signals of the generator drive signal. At resonance, the phase difference between the current and voltage signals is zero. The phase changes as the ultrasonic system goes out of resonance. Various algorithms can be used to detect the phase difference and adjust the drive frequency until the ultrasonic system returns to resonance, that is, the phase difference between the current and voltage signals reaches zero. Phase information can also be used to infer the conditions of the ultrasonic blade. As discussed in detail below, the phase changes as a function of the temperature of the ultrasonic blade. Therefore, the phase information can be used to control the temperature of the ultrasonic blade. This can be done, for example, by reducing the power supplied to the ultrasonic blade when the ultrasonic blade is too hot and by increasing the power applied to the ultrasonic blade when the ultrasonic blade is too cold.

[0465] Various aspects of the generator may have a wider range of frequencies and increased output power required to drive ultrasonic surgical devices and electrosurgical devices. The lower the voltage, the greater the current demand of electrosurgical devices can be met by a dedicated tap on a wideband power transformer, thus eliminating the need for a separate power amplifier and output transformer. Additionally, the generator's sensing and feedback circuits can support a wide dynamic range that meets the needs of ultrasonic applications and electrosurgical applications with minimal distortion.

[0466] Various aspects may provide a simple and economical means for the generator to read and optionally write to a data circuit (e.g., a single wire bus device, such as a single wire protocol EEPROM, known under the trade name " 1-Wire") arranged in an instrument attached to the handpiece using existing multiconductor generator/handle cables. In this way, the generator is capable of retrieving and processing instrument-specific data from an instrument attached to the handle. This can allow the generator to provide better control and improved diagnostics and error detection. Additionally, the generator's ability to write data to the instrument enables new functionality in terms of, for example, tracking instrument usage and capturing operational data. Additionally, the use of the frequency range allows backward compatibility of instruments containing a bus device with existing generators.

[0467] Described aspects of the generator provide active cancellation of leakage current caused by unintentional capacitive coupling between non-isolated and isolated patient circuits of the generator. In addition to reducing risks to the patient, reducing leakage current can also reduce electromagnetic emissions.

[0468] These and other benefits of aspects of the present description will be evident from the description presented below.

[0469] It will be recognized that the terms "proximal" and "distal" are used herein with reference to the physician's act of tightening a handle. Thus, an end actuator is distal to the most proximal handle. It will be further recognized that, for the sake of convenience and clarity, spatial terms such as "top" and "bottom" may also be used in the present invention in relation to the doctor holding the handle. However, surgical devices are used in many orientations and positions, and such terms are not intended to be limiting and absolute.

[0470] Figure 46 is an exploded elevation view of modular handheld ultrasonic surgical instrument 6480 showing the left half of the housing removed from a grip assembly 6482 and exposing a device identifier communicatively coupled to the cable terminal assembly. multiple conductors, in accordance with an aspect of the present description. In additional aspects of the present disclosure, an intelligent (or "smart") battery is used to power the modular handheld ultrasonic surgical instrument 6480. However, the smart battery is not limited to the modular handheld ultrasonic surgical instrument 6480 and, as will be explained , can be used in a variety of devices, which may or may not have power requirements (e.g., current and voltage) that vary relative to each other. The smart battery pack 6486, in accordance with one aspect of the present disclosure, is advantageously capable of identifying the specific device to which it is electrically coupled. This is done through encrypted or unencrypted identification methods. For example, a smart battery pack 6486 may have a connection portion, such as connection portion 6488. The grip assembly 6482 may also be provided with a device identifier communicatively coupled to the multi-conductor cable terminal assembly. 6491 and operable to communicate at least one information about the 6482 grip assembly. This information may refer to the number of times the 6482 grip assembly has been used, the number of times a 6484 ultrasonic transducer/generator assembly (currently disconnected) of the 6482 handle assembly) has been used, the number of times a 6490 drive shaft waveguide assembly (currently connected to the 6482 handle assembly) has been used, the type of 6490 drive shaft waveguide assembly that is currently connected to the 6482 handle assembly, the type or identity of the 6484 ultrasonic transducer/generator assembly that is currently connected to the 6482 handle assembly, and/or many other characteristics. When the smart battery pack 6486 is inserted into the grip assembly 6482, the connecting portion 6488 within the smart battery pack 6486 makes communication contact with the device identifier of the grip assembly 6482. The grip assembly 6482, e.g. through hardware, software, or a combination thereof, is capable of transmitting information to the smart battery pack 6486 (either by self-initiation or in response to a request from the smart battery pack 6486). This communicated identifier is received by the connection portion 6488 of the smart battery pack 6486. In one aspect, when the smart battery pack 6486 receives the information, the communication portion is operable to control the output of the smart battery pack 6486 to meet to the specific power requirements of the device.

[0471] In one aspect, the communication portion includes a processor 6493 and a memory 6497 that may be separate or a single component. The 6493 processor, in combination with memory, is capable of providing intelligent power management for the 6480 Modular Handheld Ultrasonic Surgical Instrument. This aspect is particularly advantageous due to the fact that an ultrasonic device such as the 6480 Modular Handheld Ultrasonic Surgical Instrument 6480, has a power requirement (frequency, current, and voltage) that may be unique to the modular handheld ultrasonic surgical instrument 6480. In fact, the modular handheld ultrasonic surgical instrument 6480 may have a specific power requirement or limitation for a dimension or type of external tube 6494 and a second different power requirement for a second type of waveguide having a different dimension, shape and/or configuration.

[0472] A smart battery pack 6486, in accordance with at least one aspect of the present description, therefore enables a battery pack to be used among multiple surgical instruments. Due to the fact that the 6486 Smart Battery Pack is able to identify which device it is attached to and is consequently able to change its output, operators of several different surgical instruments utilizing the 6486 Smart Battery Pack no longer need to worry about which power source they are trying to install inside the electronic device being used. This is particularly advantageous in an operational environment where a battery pack needs to be replaced or interchanged with another surgical instrument in the middle of a complex surgical procedure.

[0473] In another aspect of the present disclosure, the smart battery pack 6486 stores, in a memory 6497, a record each time a specific device is used. This record can be useful in evaluating the end of useful or permitted life of a device. For example, after a device is used 20 times, the batteries in the 6486 Smart Battery Pack connected to the device will refuse to supply power to the device - since the device is defined as a "no longer reliable" surgical instrument. Reliability is determined based on several factors. One factor may be wear and tear, which can be estimated in several ways, including the number of times the device has been used or activated. After a certain number of uses, parts of the device may become worn and tolerances between parts may be exceeded. For example, the intelligent battery pack 6486 may detect the number of times the button is pressed by the grip assembly 6482 and may determine when a maximum number of times the button is pressed has been reached or exceeded. The 6486 Smart Battery Pack can also monitor an impedance of the button mechanism that may change, for example, if the grip becomes contaminated, for example, with saline.

[0474] This wear and tear can lead to unacceptable failure during a procedure. In some aspects, the 6486 smart battery pack can recognize which parts are combined into a device and even how many uses a part has experienced. For example, if the smart battery pack 6486 is a smart battery according to the present description, it may identify the grip assembly 6482, the drive shaft waveguide assembly 6490, as well as the transducer/ ultrasonic generator 6484, long before the user tries to use the composite device. The memory 6497 within the intelligent battery pack 6486 may, for example, record a time when the ultrasonic transducer/generator assembly 6484 is operated and how, when, and for how long it is operated. If the 6484 ultrasonic transducer/generator assembly has an individual identifier, the 6486 intelligent battery pack may monitor the use of the 6484 ultrasonic transducer/generator assembly and refuse to supply power to that 6484 ultrasonic transducer/generator assembly when the 6482 handle or 6484 ultrasonic transducer/generator assembly exceeds its maximum number of uses. The 6484 ultrasonic transducer/generator assembly, the 6482 grip assembly, the 6490 drive shaft waveguide assembly, or other components may include a memory integrated circuit (chip) that also records this information. This way, any number of smart batteries in the 6486 Smart Battery Pack can be used with any number of 6484 Ultrasonic Transducer/Generator Packs, staplers, vessel seals, etc. and also be able to determine the total number of uses, or the total time of use (through the use of the clock), or the total number of actuations, etc. 6484 ultrasonic transducer/generator assembly, stapler, bottle seal, etc. or charge or discharge cycles. The smart functionality may reside outside of the battery pack 6486 and may reside in the grip assembly 6482, the ultrasonic transducer/generator assembly 6484, and/or the drive shaft assembly 6490, for example.

[0475] By accounting for uses of the 6484 ultrasonic transducer/generator assembly to intelligently end the useful life of the 6484 ultrasonic transducer/generator assembly, the surgical instrument accurately distinguishes between the completion of an actual use of the transducer assembly /ultrasonic generator 6484 in a surgical procedure and a momentary lapse in actuation of the ultrasonic transducer/generator assembly 6484 due to, for example, a battery change or a temporary delay in the surgical procedure. Therefore, as an alternative to simply counting the number of activations of the 6484 ultrasonic transducer/generator assembly, a real-time clock circuit (RTC) can be implemented to monitor the amount of time that the 6484 ultrasonic transducer/generator assembly is actually turned off. From the measured length of time, it can be determined, through appropriate logic, whether the shutdown was significant enough to be considered the end of actual use or whether the shutdown was too short in terms of time to be considered the end. end of use. Therefore, in some applications, this method may be a more accurate determination of the useful life of the 6484 ultrasonic transducer/generator assembly than a simple "activations-based" algorithm, which may, for example, report that ten "activations" occur in a surgical procedure and, therefore, ten activations should indicate that the counter is incremented one by one. Generally speaking, this type of internal time counting system will prevent incorrect use of the device that is designed to fool a simple "activation-based" algorithm, and will prevent incorrect recording of a complete use in cases where there has only been a simple loss. of the 6484 Ultrasonic Transducer/Generator Assembly or the 6486 Smart Battery Pack that was required for legitimate reasons.

[0476] Although the ultrasonic transducer/generator assemblies 6484 of the surgical instrument 6480 are reusable, in one aspect a finite number of uses can be defined since the surgical instrument 6480 is subject to rigorous conditions during cleaning and sterilization. More specifically, the battery is configured to be sterilized. Regardless of the material used for external surfaces, there is a limited expected lifespan for the actual materials used. This useful life is determined by several characteristics that could include, for example, the number of times the battery has actually been sterilized, the time since the battery was manufactured, and the number of times the battery has been recharged, to name a few. Additionally, the lifespan of the battery cells themselves is limited. The software of the present disclosure incorporates algorithms of the invention that check the number of uses of the ultrasonic transducer/generator assembly 6484 and the smart battery pack 6486 and disable the device when that number of uses has been reached or exceeded. Analysis of the exterior of the battery in each of the possible sterilization methods can be performed. Based on the most stringent sterilization procedure, the maximum number of sterilizations allowed can be set and this number can be stored in a memory of the 6486 Smart Battery Pack. If it is assumed that a charger is non-sterile and the Smart Battery Pack 6486 must be used after being charged, so the charge count can be set to be equal to the number of sterilizations found for that specific battery.

[0477] In one aspect, the hardware in the battery may be disabled to minimize or eliminate safety concerns due to continued depletion of the battery cells after the battery has been disabled by software. There may be a situation where the battery's internal hardware is unable to disable the battery under certain low voltage conditions. In this situation, in one aspect, the charger can be used to "kill" the battery. Due to the fact that the battery microcontroller is turned off while the battery is in its charger, non-volatile System Management Bus (SMB)-based programmable and electrically erasable read-only memory (EEPROM) can be used to exchange information between the battery microcontroller and charger. In this way, a serial EEPROM can be used to store information that can be written and read even when the battery microcontroller is turned off, which is very beneficial when trying to exchange information with the charger or other peripheral devices. This exemplary EEPROM may be configured to contain sufficient memory registers to store at least (a) a threshold usage count at which the battery must be disabled (Battery Usage Count), (b) the number of procedures for which the battery was subjected (Battery Procedure Count) and/or (c) a number of charges to which the battery was subjected (Charge Count), among others. Some of the information stored in EEPROM, such as the Usage Count Register and Charge Count Register, is stored in write-protected sections of EEPROM to prevent users from changing the information. In one aspect, usage and counters are stored with corresponding bit-flipped secondary registers to detect data corruption.

[0478] Any residual voltage on the SMBus lines (system management bus) could damage the microcontroller and corrupt the SMBus signal. Therefore, to ensure that the SMBus lines of a battery controller do not contain a voltage while the microcontroller is powered off, relays are provided between the external SMBus lines and the battery controller microboard.

[0479] During charging of the smart battery pack 6486, an "end of charge" condition of the batteries within the smart battery pack 6486 is determined when, for example, the current flowing into the battery drops below a limit determined in a funneled manner when employing a constant current/constant voltage charging scheme. To accurately detect this "end of charge" condition, the battery microcontroller and step-down plates are de-energized and turned off during battery charging to reduce any current drain that may be caused by the plates and which may interfere with current sensing. decreasing. Additionally, the microcontroller and step-down boards are de-energized during charging to prevent any resulting corruption of the SMBus signal.

[0480] With respect to the charger, in one aspect, the smart battery pack 6486 is prevented from being inserted into the charger in a manner other than the correct insertion position. Accordingly, the exterior of the smart battery pack 6486 is provided with features of charger attachment. A container for securely attaching the 6486 smart battery pack to the charger is configured with a contour-matching conical geometry to prevent accidental insertion of the 6486 smart battery pack in any way other than the correct (intended) shape. It is further contemplated that the presence of the smart battery pack 6486 may be detectable by the charger itself. For example, the charger can be configured to detect the presence of SMBus transmission from the battery protection circuit as well as the resistors that are located on the protection board. In this case, the charger would be enabled to control a voltage that is exposed to the charger pins until the 6486 Smart Battery Pack is properly seated or in place on the charger. This is due to the fact that an exposed voltage on the charger pins can present a hazard and a risk that an electrical short circuit could occur across the pins and cause the charger to be inadvertently charged.

[0481] In some aspects, the smart battery pack 6486 may communicate with the user through auditory and/or visual feedback. For example, the 6486 smart battery pack can make LEDs emit light in a predefined way. In this case, although the microcontroller in the 6484 ultrasonic transducer/generator assembly controls the LEDs, the microcontroller receives instructions to execute directly from the 6486 smart battery assembly.

[0482] In yet another aspect of the present disclosure, the microcontroller in the 6484 ultrasonic transducer/generator assembly, when not in use for a predetermined period, enters sleep mode. Advantageously, when in sleep mode, the microcontroller clock speed is reduced, significantly cutting current drain. Some current continues to be consumed because the processor continues sending a signal, waiting to detect an input. Advantageously, when the microcontroller is in this power-saving sleep mode, the microcontroller and battery controller can directly control the LEDs. For example, a decoder circuit could be built into the 6484 ultrasonic transducer/generator assembly and connected to the communication lines so that the LEDs can be controlled independently by the 6493 processor while the 6484 ultrasonic transducer/generator assembly microcontroller is "OFF " or in a "suspend mode". This is a power saving feature that eliminates the need to power the microcontroller in the 6484 ultrasonic transducer/generator assembly. Power is saved by allowing the generator to be turned off while still being able to actively control the user interface indicators.

[0483] Another aspect slows down one or more of the microcontrollers to conserve power when not in use. For example, the clock frequencies of both microcontrollers can be reduced to save power. To maintain synchronized operation, microcontrollers coordinate the change of their respective clock frequencies so that both the reduction and subsequent increase in frequency occur at approximately the same time when full speed operation is required. For example, when entering idle mode, clock frequencies are decreased and when exiting idle mode, frequencies are increased.

[0484] In a further aspect, the intelligent battery pack 6486 is capable of determining the amount of usable power remaining within its cells and is programmed to only operate the surgical instrument to which it is connected if it determines that there is remaining battery power. sufficient to predictably operate the device throughout the intended procedure. For example, the 6486 Smart Battery Pack is capable of remaining in a non-operational state if there is not enough power within the cells to operate the surgical instrument for 20 seconds. In one aspect, the intelligent battery pack 6486 determines the amount of energy remaining within the cells at the end of its most recent previous function, e.g., a surgical cut. In this regard, therefore, the smart battery pack 6486 would not enable a subsequent function to be performed if, for example, during that procedure, the pack determined that the cells did not have sufficient power. Alternatively, if the 6486 Smart Battery Pack determines that there is sufficient power for a subsequent procedure and falls below that threshold during the procedure, it does not interrupt the ongoing procedure and instead enables the procedure to be terminated and subsequently prevents new procedures to occur.

[0485] The following explains an advantage of maximizing the use of the device with the smart battery pack 6486 of the present disclosure. In this example, a set of different devices have different ultrasonic transmission waveguides. By definition, waveguides could have a respective maximum allowable energy limit, where exceeding said energy limit overloads the waveguide and ultimately causes it to fracture. One waveguide from the waveguide array will naturally have the lowest maximum power tolerance. Since prior art batteries do not have intelligent battery power management, the output of prior art batteries needs to be limited by a value of the lowest allowable maximum power input for the smaller/narrower/more fragile waveguide. in the set intended to be used with the device/battery. This would be true even if larger, thicker waveguides could later be attached to that grip and, by definition, enable greater force to be applied. This limitation is also true for maximum battery power. For example, if a battery is designed to be used in multiple devices, its maximum power output will be limited to the lowest maximum power rating of any of the devices in which it is to be used. With this configuration, one or more devices or device configurations would not be able to maximize battery usage since the battery does not know the specific limits of the specific device.

[0486] In one aspect, the smart battery pack 6486 can be used to intelligently bypass the aforementioned limitations of the ultrasonic device. The smart battery pack 6486 may produce an output for a specific device or device configuration and the same smart battery pack 6486 may later produce a different output for a second device or device configuration. This universal smart surgical battery system lends itself well to modern operating rooms where space and time are limited. By having a smart battery powering multiple different devices, nursing teams can easily manage the storage, retrieval, and inventory of these batteries. Advantageously, in one aspect, the intelligent battery system according to the present disclosure may employ a type of charging station, thereby increasing the ease and efficiency of use and decreasing the costs of operating room charging equipment. .

[0487] Additionally, other surgical instruments, e.g., an electric stapler, may have a different power requirement than that of the modular handheld ultrasonic surgical instrument 6480. In accordance with various aspects of the present disclosure, a smart battery pack 6486 may be used with any of a number of surgical instruments and can be produced to adapt its own power output to the specific device in which it is installed. In one aspect, this power adaptation is achieved by controlling the duty cycle of a switching mode power supply, e.g., a buck, step-down, buck-boost, step-up configuration, or other configuration, integrated or otherwise coupled to and controlled by the 6486 Smart Battery Pack. In other aspects, the 6486 smart battery pack can dynamically change its power output during device operation. For example, in vessel sealing devices, energy management enables improved tissue sealing. In these devices, high constant current values are required. The total power output needs to be dynamically adjusted because as the tissue is sealed, its impedance changes. Aspects of the present disclosure provide the 6486 smart battery pack with a variable maximum current limit. The current limit may vary from one application (or device) to another, based on the requirements of the application or device.

[0488] Figure 47 is a detail view of a trigger portion 6483 and a key of the ultrasonic surgical instrument 6480 shown in Figure 46, in accordance with an aspect of the present description. The trigger 6483 is operatively coupled to the gripper member 6495 of the end actuator 6492. The ultrasonic blade 6496 is energized by the ultrasonic transducer/generator assembly 6484 upon activation of the activation switch 6485. Continuing now with Figure 46, and also looking For Figure 47, trigger 6483 and activation switch 6485 are shown as components of grip assembly 6482. Trigger 6483 activates end actuator 6492, which has a cooperative association with the ultrasonic blade 6496 of the waveguide assembly. of the drive shaft 6490 to enable various types of contact between the gripper member 6495 of the end actuator and the ultrasonic blade 6496 with tissue and/or other substances. The gripper member 6495 of the end actuator 6492 is generally a hinged gripper that acts to grip or hold tissue disposed between the gripper and the ultrasonic blade 6496. In one aspect, audible feedback is provided at the trigger that makes a "click" when the trigger is fully depressed. The noise may be generated by a thin metal part that the trigger touches during closing. This feature adds an audible component to the user feedback that informs the user that the clamp is fully compressed against the waveguide and that sufficient locking pressure is being applied to seal the vessel. In another aspect, force sensors, such as mechanical tension gauges or pressure sensors, may be coupled to the trigger 6483 to measure the force applied to the trigger 6483 by the user. In another aspect, force sensors, such as mechanical strain gauges or pressure sensors, may be coupled to the switch button 6485 so that the magnitude of the displacement corresponds to the force applied by the user to the switch button 6485.

[0489] The activation switch 6485, when pressed, places the modular handheld ultrasonic surgical instrument 6480 into an ultrasonic operating mode, which causes ultrasonic movement in the drive shaft waveguide assembly 6490. In one aspect, the Pressing the 6485 activation switch causes the electrical contacts inside the switch to close, thus completing a circuit between the 6486 smart battery pack and the 6484 ultrasonic transducer/generator assembly so that electrical power is applied to the transducer ultrasonic, as previously described. In another aspect, pressing the activation switch 6485 closes the electrical contacts for the smart battery pack 6486. Of course, the electrical closing contacts in a circuit are here merely an example of a general description of the operation of the switch. There are many alternative aspects that may include contact opening or processor-controlled power supply that receives information from the switch and directs a corresponding circuit reaction based on the information.

[0490] Figure 48 is a fragmentary enlarged perspective view of an end actuator 6492, in accordance with at least one aspect of the present description, from a distal end with a claw member 6495 in an open position. Referring to Figure 48, a partial perspective view of the distal end 6498 of the drive shaft waveguide assembly 6490 is shown. The waveguide drive shaft assembly 6490 includes an external tube 6494 that surrounds a portion of the waveguide. The ultrasonic blade portion 6496 of the waveguide 6499 projects from the distal end 6498 of the outer tube 6494. It is the ultrasonic blade portion 6496 that contacts tissue during a medical procedure and transfers its ultrasonic energy to the tissue. The waveguide drive shaft assembly 6490 also includes a gripper member 6495 that is coupled to the outer tube 6494 and an inner tube (not visible in this view). The gripper member 6495, with the inner and outer tubes and the ultrasonic blade portion 6496 of the waveguide 6499, may be called an end actuator 6492. As will be explained below, the outer tube 6494 and the inner tube do not illustrated slide longitudinally relative to each other. As relative movement occurs between the outer tube 6494 and the inner tube not illustrated, the gripper member 6495 pivots about a pivot point, thereby causing the gripper member 6495 to open and close. When closed, the claw member 6495 imparts a clamping force on the tissue located between the claw member 6495 and the ultrasonic blade 6496, ensuring positive and efficient contact between the blade and the tissue.

[0491] Figure 49 is a system diagram 7400 of a segmented circuit 7401 comprising a plurality of independently operated circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440, in accordance with at least one aspect of the this description. A circuit segment of the plurality of circuit segments of the segmented circuit 7401 comprises one or more circuits and one or more sets of machine-executable instructions stored in one or more memory devices. The one or more circuits of a circuit segment are coupled for electrical communication through one or more wired or wireless connection means. The plurality of circuit segments are configured to transition between three modes comprising a sleep mode, a standby mode, and an operating mode.

[0492] In one aspect shown, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 first begin in standby mode, secondly transition to suspend mode, and then thirdly, it switches to operational mode. However, in other aspects, the plurality of circuit segments may transition from any of the three modes to any of the other three modes. For example, the plurality of circuit segments may transition directly from standby mode to operating mode. Individual circuit segments may be placed in a specific state by the voltage control circuit 7408 based on execution by a machine-executable instruction processor. The states comprise a de-energized state, a low-energy state, and an energized state. The off state corresponds to sleep mode, the low power state corresponds to standby mode, and the on state corresponds to operating mode. The transition to the low energy state can be achieved, for example, by using a potentiometer.

[0493] In one aspect, the plurality of circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 may transition from suspend mode or standby mode to operational mode in accordance with a sequence of energization. The plurality of circuit segments may also transition from operating mode to standby mode or suspend mode in accordance with the de-energization sequence. The power-on sequence and power-off sequence may be different. In some aspects, the energization sequence comprises energizing only a subset of circuit segments of the plurality of circuit segments. In some aspects, the de-energization sequence comprises de-energizing only a subset of circuit segments of the plurality of circuit segments.

[0494] Again referring to system diagram 7400 in Figure 49, segmented circuit 7401 comprises a plurality of circuit segments comprising a transition circuit segment 7402, a processor circuit segment 7414, a grip circuit segment 7416, a communication circuit segment 7420, a display circuit segment 7424, a motor control circuit segment 7428, a power handling circuit segment 7434, and a drive shaft circuit segment 7440. The segment The transition circuit segment comprises an activation circuit 7404, a step-up current circuit 7406, a voltage control circuit 7408, a safety controller 7410, and a POST controller 7412. The transition circuit segment 7402 is configured to implement a power-down sequence and a power-up sequence, a safety detection protocol, and a POST.

[0495] In some aspects, the activation circuit 7404 comprises an accelerometer button sensor 7405. In aspects, the transition circuit segment 7402 is configured to be in an energized state, while other circuit segments of the plurality of activation segments circuit of the segmented circuit 7401 are configured to be in a low power state, an off state, or an on state. The accelerometer button sensor 7405 can monitor the movement or acceleration of the surgical instrument 6480 described in the present invention. For example, the movement may be a change in the orientation or rotation of the surgical instrument. The surgical instrument can be moved in any direction in relation to a three-dimensional Euclidean space, for example, by a user of the surgical instrument. When the accelerometer button sensor 7405 detects motion or acceleration, the accelerometer button sensor 7405 sends a signal to the voltage control circuit 7408 to cause the voltage control circuit 7408 to apply voltage to the processor circuit segment 7414 to transition the processor and volatile memory to a powered state. In aspects, the processor and volatile memory are in a powered state before the voltage control circuit 7409 applies voltage to the processor and volatile memory. In operational mode, the processor can initiate a power-on sequence or a power-off sequence. In various aspects, the accelerometer button sensor 7405 may also send a signal to the processor to cause the processor to initiate a power-on sequence or a power-off sequence. In some aspects, the processor initiates a power-up sequence when most of the individual circuit segments are in a low-power state or in a de-energized state. In other aspects, the processor initiates a power-down sequence when the majority of the individual circuit segments are in a powered state.

[0496] Additionally or alternatively, the accelerometer button sensor 7405 may detect external movement within a predetermined vicinity of the surgical instrument. For example, the accelerometer button sensor 7405 may detect the movement of the hand of a user of the surgical instrument 6480 described herein, which moves within the predetermined neighborhood. When the accelerometer button sensor 7405 detects this external movement, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor as previously described. After receiving the sent signal, the processor can initiate a power-on sequence or an off-power sequence to transition one or more circuit segments between the three modes. In aspects, the signal sent to the voltage control circuit 7408 is sent to verify that the processor is in operational mode. In some aspects, the accelerometer button sensor 7405 may detect when the surgical instrument has been dropped and send a signal to the processor based on the detected drop. For example, the signal may indicate an error in the operation of an individual circuit segment. One or more sensors can detect damage or failure of the individual circuit segments affected. Based on the detected damage or failure, the 7412 POST controller can perform a POST of the corresponding individual circuit segments.

[0497] A power-on sequence or a power-off sequence may be defined based on the accelerometer button sensor 7405. For example, the accelerometer button sensor 7405 may detect a specific movement or sequence of movements that indicates the selection of a specific circuit segment of the plurality of circuit segments. Based on the detected motion or series of detected motions, the accelerometer button sensor 7405 may transmit a signal comprising an indication of one or more circuit segments of the plurality of circuit segments to the processor when the processor is in a powered state. Based on the signal, the processor determines a power-up sequence comprising the one or more selected circuit segments. Additionally or alternatively, a user of the surgical instruments 6480 described herein may select a number and order of circuit segments to define a power-on sequence or a power-off sequence based on interaction with a graphical user interface (GUI) of the surgical instrument. .

[0498] In various aspects, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor only when the accelerometer button sensor 7405 detects movement of the surgical instrument 6480 described herein or the movement external within a predetermined neighborhood above a predetermined threshold. For example, a signal can only be sent if motion is detected for 5 or more seconds or if the surgical instrument is moved 5 or more inches. In other aspects, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor only when the accelerometer button sensor 7405 detects oscillatory movement of the surgical instrument. A predetermined threshold reduces inadvertent transition of surgical instrument circuit segments. As previously described, the transition may comprise a transition to the operating mode in accordance with a power-up sequence, a transition to the low-power mode in accordance with a power-down sequence, or a transition to the sleep mode in accordance with a power-down sequence. de-energization. In some aspects, the surgical instrument comprises an actuator that can be actuated by a user of the surgical instrument. Actuation is detected by the 7405 accelerometer button sensor. The actuator can be a sliding element, a toggle switch, or a momentary contact switch. Based on the detected actuation, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor.

[0499] The amplification current circuit 7406 is coupled to the battery. The 7406 amplification current circuit is a current amplifier, such as a relay or transistor, and is configured to amplify the magnitude of a current of an individual circuit segment. The magnitude of the initial current corresponds to the source voltage supplied by the battery to the 7401 segmented circuit. Suitable relays include solenoids. Suitable transistors include field effect transistors (FET), MOSFET and bipolar junction transistors (BJT). The amplification current circuit 7406 may amplify the current magnitude corresponding to an individual circuit segment or the circuit that requires the most current extraction during the operation of the surgical instruments 6480 described herein. For example, an increase in current to the motor control circuit segment 7428 may be provided when a surgical instrument motor requires more input power. The increase in current supplied to an individual circuit segment may cause a corresponding reduction in current to another circuit segment or circuit segments. Additionally or alternatively, the increase in current may correspond to the voltage supplied by an additional voltage source operating in conjunction with the battery.

[0500] Voltage control circuit 7408 is coupled to the battery. The voltage control circuit 7408 is configured to supply voltage to or remove voltage from the plurality of circuit segments. The voltage control circuit 7408 is also configured to increase or reduce a voltage supplied to the plurality of circuit segments of the segmented circuit 7401. In various aspects, the voltage control circuit 7408 comprises a combinational logic circuit such as a multiplexer (MUX). to select the inputs, a plurality of electronic switches and a plurality of voltage converters. An electronic switch of the plurality of electronic switches may be configured to switch between an open and a closed configuration to disconnect or connect an individual circuit segment to or from the battery. The plurality of electronic switches may consist of solid-state devices such as transistors or other types of switches, such as wireless switches, ultrasonic switches, accelerometers, inertial sensors, among others. The combinational logic circuit is configured to select an individual electronic switch to perform switching to an open configuration to allow voltage to be applied to the corresponding circuit segment. The combined logic circuit is also configured to select an individual electronic switch to perform switching to a closed configuration to allow removal of voltage from the corresponding circuit segment. By selecting a plurality of individual electronic switches, the combined logic circuit can implement a de-energization sequence or an energization sequence. The plurality of voltage converters can provide an up-step voltage or a down-step voltage to a plurality of circuit segments. The voltage control circuit 7408 may also comprise a microprocessor and a memory device.

[0501] Safety controller 7410 is configured to perform safety checks on circuit segments. In some aspects, the 7410 safety controller performs safety checks when one or more individual circuit segments are in operational mode. Safety checks can be performed to determine whether or not there are any errors or defects in the functioning or operation of the circuit segments. The safety controller 7410 may monitor one or more parameters of the plurality of circuit segments. The safety controller 7410 can verify the identity and operation of the plurality of circuit segments by comparing the one or more parameters with predefined parameters. For example, if an RF energy modality is selected, the safety controller 7410 may check whether a drive shaft articulation parameter matches a predefined articulation parameter to verify operation of the RF energy modality of the surgical instrument 6480 described in the present invention. In some aspects, the safety controller 7410 may monitor, through the sensors, a predetermined relationship between one or more properties of the surgical instrument to detect a defect. A defect may occur when one or more properties are inconsistent with the predetermined relationship. When the safety controller 7410 determines that a defect, an error exists, or that some operation of the plurality of circuit segments has not been verified, the safety controller 7410 prevents or disables operation of the specific circuit segment where the defect, error, or failure occurred. verification checks were originated.

[0502] POST controller 7412 performs a POST to verify proper operation of the plurality of circuit segments. In some aspects, POST is performed to an individual circuit segment of the plurality of circuit segments before the voltage control circuit 7408 applies a voltage to the individual circuit segment to transition the individual circuit segment from standby mode. or from suspend mode to operational mode. If the individual circuit segment does not pass POST, the specific circuit segment does not transition from standby or suspend mode to operational mode. The POST of the grip circuit segment 7416 may comprise, for example, testing whether the grip control sensors 7418 detect an actuation of a grip control of the surgical instrument 6480 described herein. In some aspects, the POST controller 7412 may transmit a signal to the accelerometer button sensor 7405 to verify the operation of the individual circuit segment as part of the POST. For example, after receiving the signal, the accelerometer button sensor 7405 may instruct a user of the surgical instrument to move the surgical instrument to a plurality of variable locations to confirm the operation of the surgical instrument. The 7405 accelerometer button sensor may also monitor an output from a circuit segment or a circuit from a circuit segment as part of POST. For example, accelerometer button sensor 7405 may detect an incremental motor pulse generated by motor 7432 to verify operation. A motor controller of the motor control circuit 7430 may be used to control the motor 7432 to generate the incremental motor pulse.

[0503] In various aspects, the surgical instrument 6480 described herein may comprise additional accelerometer button sensors. The POST controller 7412 may also execute a control program stored in the memory device of the voltage control circuit 7408. The control program may cause the POST controller 7412 to transmit a signal that requests a correlated encrypted parameter from a plurality of circuit segments. Failure to receive a correlated encrypted parameter from an individual circuit segment indicates to the POST controller 7412 that the corresponding circuit segment is damaged or defective. In some aspects, if the POST controller 7412 determines, based on POST, that the processor is damaged or defective, the POST controller 7412 may send a signal to one or more secondary processors to cause the one or more secondary processors to perform critical functions that the processor is unable to perform. In some aspects, if the POST controller 7412 determines, based on POST, that one or more circuit segments do not operate properly, the POST controller 7412 may initiate a reduced performance mode of those circuit segments that operate properly, while blocking those circuit segments that do not pass POST or that do not operate properly. A blocked circuit segment can function similarly to a circuit segment in standby or suspended mode.

[0504] Processor circuit segment 7414 comprises the processor and volatile memory. The processor is configured to initiate a power-on sequence or a power-off sequence. To initiate the power-up sequence, the processor transmits a power-on signal to the voltage control circuit 7408 to cause the voltage control circuit 7408 to apply voltage to the plurality or a subset of the plurality of circuit segments in accordance with the power-up sequence. To initiate the power-down sequence, the processor transmits a power-down signal to the voltage control circuit 7408 to cause the voltage control circuit 7408 to remove voltage from the plurality or a subset of the plurality of circuit segments in accordance with the de-energization sequence.

[0505] The grip circuit segment 7416 comprises grip control sensors 7418. The grip control sensors 7418 can detect an actuation of one or more grip controls of the surgical instrument 6480 described herein. In various aspects, the one or more grip controls comprise a claw control, a release button, a toggle switch, a power activation button, and/or any other suitable grip control. The user can activate the power enable button to select between an RF power mode, an ultrasonic power mode, or a combined RF and ultrasonic power mode. The 7418 grip control sensors can also facilitate the attachment of a modular grip to the surgical instrument. For example, grip control sensors 7418 may detect proper attachment of the modular handle to the surgical instrument and indicate the detected attachment to a user of the surgical instrument. The 7426 LCD screen can provide a graphical indication of the detected fixation. In some aspects, the 7418 grip control sensors detect the actuation of one or more grip controls. Based on the detected actuation, the processor can initiate either a power-on sequence or a power-off sequence.

[0506] The communication circuit segment 7420 comprises a communication circuit 7422. The communication circuit 7422 comprises a communication interface for facilitating signal communication between the individual circuit segments of the plurality of circuit segments. In some aspects, the communication circuit 7422 provides a path for the modular components of the surgical instrument 6480 described herein to communicate electrically. For example, a modular drive shaft and a modular transducer, when attached together to the surgical instrument handle, can upload control programs to the handle via the 7422 communication circuit.

[0507] The screen circuit segment 7424 comprises an LCD screen 7426. The LCD screen 7426 may comprise a liquid crystal display, LED indicators, etc. In some aspects, the 7426 LCD display is an organic light-emitting diode (OLED) display. A screen may be placed on, embedded in, or located remotely from the surgical instrument 6480 described herein. For example, the screen can be placed on the handle of the surgical instrument. The screen is configured to provide sensory feedback to a user. In several aspects, the 7426 LCD screen further comprises a backlight. In some aspects, the surgical instrument may also comprise audio feedback devices such as a speaker or a sound signal and tactile feedback devices such as a haptic actuator.

[0508] Motor control circuit segment 7428 comprises a motor control circuit 7430 coupled to a motor 7432. The motor 7432 is coupled to the processor by a driver and a transistor, such as a FET. In various aspects, the 7430 motor control circuit comprises a motor current sensor in signal communication with the processor to provide a signal indicative of a measurement of current draw from the motor to the processor. The processor transmits the signal to the screen. The screen receives the signal and displays the 7432 motor current draw measurement. The processor may use the signal, for example, to monitor that the 7432 motor current draw exists within an acceptable range to compare the current draw with one or more parameters of the plurality of circuit segments, and to determine one or more parameters of a patient treatment site. In various aspects, the 7430 motor control circuit comprises a motor controller for controlling the operation of the motor. For example, the 7430 motor control circuit controls various motor parameters, for example, by adjusting the speed, torque, and acceleration of the 7432 motor. The adjustment is performed based on the current passing through the 7432 motor, measured by the motor current sensor.

[0509] In various aspects, the motor control circuit 7430 comprises a force sensor for measuring the force and torque generated by the motor 7432. The motor 7432 is configured to actuate a mechanism of the surgical instruments 6480 described herein. For example, the 7432 motor is configured to control the actuation of the surgical instrument drive shaft to perform gripping, rotation, and articulation functionalities. For example, the 7432 motor may actuate the drive shaft to perform a grasping movement with the jaws of the surgical instrument. The motor controller can determine whether the material held by the grippers is fabric or metal. The motor controller can also determine the extent to which the grippers grip the material. For example, the motor controller may determine how to open or close the grippers based on the derivation of the detected motor current or motor voltage. In some aspects, the 7432 motor is configured to actuate the transducer to cause the transducer to apply torque to the handle or control the articulation of the surgical instrument. The motor current sensor can interact with the motor controller to set a motor current limit. When the current satisfies the preset threshold limit, the motor controller initiates a corresponding change in a motor control operation. For example, exceeding the motor current limit causes the motor controller to reduce current draw from the motor.

[0510] The energy handling circuit segment 7434 comprises an RF amplifier and safety circuit 7436 and an ultrasonic signal generator circuit 7438 for implementing the modular energy functionality of the surgical instrument 6480 described herein. In various aspects, the RF amplifier and safety circuit 7436 are configured to control the RF modality of the surgical instrument by generating an RF signal. The 7438 ultrasonic signal generator circuit is configured to control the ultrasonic energy modality by generating an ultrasonic signal. The RF amplifier and safety circuit 7436 and an ultrasonic signal generator circuit 7438 may operate together to control the combined modality of RF and ultrasonic energy.

[0511] The drive shaft circuit segment 7440 comprises a drive shaft module controller 7442, a modular control actuator 7444, one or more end actuator sensors 7446, and a non-volatile memory 7448. The module controller drive shaft module 7442 is configured to control a plurality of drive shaft modules comprising control programs to be executed by the processor. The plurality of drive shaft modules implements a drive shaft embodiment, e.g., ultrasonic, combination of ultrasonic and RF, RF I-profile blade, and RF-opposed gripper. The 7442 drive shaft module controller can select the drive shaft mode by selecting the corresponding drive shaft module for the processor to operate. The 7444 Modular Control Actuator is configured to actuate the drive shaft according to the selected drive shaft modality. After actuation is initiated, the drive shaft articulates the end actuator according to one or more parameters, routines, or programs specific to the selected shaft modality and the selected end actuator modality. The one or more end actuator sensors 7446 located on the end actuator may include force sensors, temperature sensors, current sensors, or motion sensors. The one or more end actuator sensors 7446 transmit data about one or more end actuator operations, based on the power modality implemented by the end actuator. In various aspects, the energy modalities include an ultrasonic energy modality, an RF energy modality, or a combination of the ultrasonic energy modality and the RF energy modality. The 7448 non-volatile memory stores the drive shaft control programs. A control program comprises one or more parameters, routines or programs specific to the drive shaft. In various aspects, the non-volatile memory 7448 may be a ROM, EPROM, EEPROM or flash memory. The non-volatile memory 7448 stores the drive axis modules corresponding to the selected drive axis of the surgical instrument 6480 described herein. The drive shaft modules can be changed or updated in the non-volatile memory 7448 by the drive shaft module controller 7442 depending on the drive shaft of the surgical instrument to be used in the operation.

[0512] Figure 50 is a schematic diagram of a circuit 7925 of various components of a surgical instrument with motor control functions, in accordance with at least one aspect of the present description. In various aspects, the surgical instrument 6480 described herein may include a drive mechanism 7930 that is configured to drive drive shafts and/or gear components to perform the various operations associated with the surgical instrument 6480. In one aspect, the mechanism drive train 7930 includes a rotation drive train 7932 configured to rotate an end actuator, for example, about a longitudinal axis relative to the grip housing. The drive mechanism 7930 further includes a closure system drive train 7934 configured to close a gripper member to secure the fabric to the end actuator. Additionally, the drive mechanism 7930 includes a trigger drive train 7936 configured to open and close a clamping arm portion of the end actuator to clamp the fabric with the end actuator.

[0513] The drive mechanism 7930 includes a selector gearbox assembly 7938 that may be situated in the surgical instrument handle assembly. Proximal to the selector gearbox assembly 7938 is a function selection module including a first motor 7942 that functions to selectively move gear elements within the selector gearbox assembly 7938 to selectively position one of the drive trains 7932 , 7934, 7936 mated with an optional second motor input drive component 7944 and a motor drive circuit 7946 (shown in dotted line to indicate that the second motor 7944 and the motor drive circuit 7946 are optional components ).

[0514] Still referring to Figure 50, motors 7942 and 7944 are coupled to motor control circuits 7946, 7948, respectively, which are configured to control the operation of motors 7942 and 7944, including the flow of electrical power from a power supply 7950 for engines 7942 and 7944. Power source 7950 may be a DC battery (e.g., a rechargeable lead-based battery, nickel-based battery, lithium-ion battery, etc.) or any another power source suitable for supplying electrical energy to the surgical instrument.

[0515] The surgical instrument further includes a 7952 microcontroller ("controller"). In certain examples, controller 7952 may include a microprocessor 7954 ("processor") and one or more computer-readable media or memory units 7956 ("memory"). In certain cases, memory 7956 may store various program instructions that, when executed, may cause processor 7954 to perform a plurality of functions and/or calculations described herein. A 7950 power supply may be configured to provide power to the 7952 controller, for example.

[0516] Processor 7954 may be in communication with engine control circuitry 7946. Additionally, memory 7956 may store program instructions that, when executed by processor 7954 in response to user input 7958 or feedback elements 7960 , may cause the motor control circuit 7946 to induce the motor 7942 to generate at least one rotary motion to selectively move the gear elements within the selector gearbox assembly 7938 to selectively position one of the drive trains 7932 , 7934, 7936 to engage the input drive component of the second motor 7944. Additionally, the processor 7954 may be in communication with the motor control circuit 7948. The memory 7956 may also store program instructions that, when executed by the processor 7954 in response to a user input 7958, may cause the motor control circuit 7948 to induce the motor 7944 to generate at least one rotary motion to drive the drive train engaged with the input drive component of the second motor 7948 , for example.

[0517] The 7952 controller and/or the other controllers of the present description may be implemented using integrated and/or discrete hardware elements, software elements, and/or a combination of both. Examples of integrated hardware elements may include processors, microprocessors, microcontrollers, integrated circuits, ASICs, PLDs, DSPs, FPGAs, logic gates, registers, semiconductor devices, integrated circuits, microcircuits, chipsets, microcontrollers, system on an integrated circuit (chip). )(SoC) and/or single in-line package (SiP). Examples of discrete hardware elements may include circuits and/or circuit elements such as logic gates, field effect transistors, bipolar transistors, resistors, capacitors, inductors, and/or relays. In certain embodiments, controller 7952 may include a hybrid circuit comprising circuit elements or components integrated and isolated on one or more substrates, for example.

[0518] In certain examples, the 7952 controller and/or the other controllers of the present description may be an LM 4F230H5QR, available from Texas Instruments, for example. In certain instances, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core comprising an integrated 256 KB single-cycle flash-type memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to optimize performance above 40 MHz, a 32 KB single-cycle SRAM, internal ROM loaded with StellarisWare® software, 2KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, among other features that are readily available. Other microcontrollers can be readily substituted for use with the present disclosure. Accordingly, the present description should not be limited in that context.

[0519] In various examples, one or more of the various steps described herein may be performed by a finite state machine comprising a combinational logic circuit or a sequential logic circuit, wherein the combinational logic circuit or the sequential logic circuit is coupled, to the least, to a memory circuit. The at least one memory circuit stores a current state of the finite state machine. The combinational or sequential logic circuit is configured to make the finite state machine perform the steps. The sequential logic circuit can be synchronous or asynchronous. In other examples, one or more of the various steps described herein may be performed by a circuit including a combination of the 7958 processor and the finite state machine, for example.

[0520] In several cases, it may be advantageous to be able to assess the state of functionality of a surgical instrument to ensure its proper function. It is possible, for example, that the drive mechanism, as explained above, which is configured to include various motors, drive trains and/or gear components to perform the various operations of the surgical instrument, may wear out over time. This can occur through normal use, and in some cases the drive mechanism can wear more quickly due to abusive use conditions. In certain cases, a surgical instrument may be configured to perform self-assessments to determine the status, i.e. health, of the drive mechanism and its various components.

[0521] For example, self-assessment can be used to determine when the surgical instrument is capable of performing its function before re-sterilization or when some of the components must be replaced and/or repaired. Evaluation of the drive mechanism and its components, including but not limited to the 7932 rotation drive train, the 7934 closure system drive train, and/or the 7936 firing drive train, can be performed in several ways. shapes. The magnitude of deviation from predicted performance can be used to determine the probability of a detected failure and the severity of that failure. Various metrics can be used, including: Periodic analysis of repeatedly predictable events, increases or decreases that exceed an expected threshold, and the extent of failure.

[0522] In several cases, a signature waveform of a properly operating drive mechanism or one or more of its components can be used to evaluate the state of the drive mechanism or one or more of its components. One or more vibration sensors may be disposed relative to a properly operating drive mechanism or one or more of its components to record various vibrations occurring during the operation of the properly operating drive mechanism or one or more of its components. The recorded vibrations can be employed to create the signature waveform. Future waveforms can be compared to the signature waveform to assess the state of the drive mechanism and its components.

[0523] Still referring to Figure 50, surgical instrument 7930 includes a drive train failure detection module 7962 configured to record and analyze one or more acoustic outputs from one or more of drive trains 7932, 7934, 7936 The processor 7954 may be in communication with or otherwise control the module 7962. As described in more detail below, the module 7962 may be incorporated as various means, such as circuits, hardware, a computer program product, which comprises. a computer-readable medium (e.g., memory 7956) that stores computer-readable program instructions that are executable by a processing device (e.g., processor 7954), or some combination thereof. In some cases, processor 36 may include or otherwise control module 7962.

[0524] Again referring to Figure 51, the end actuator 8400 comprises RF data sensors 8406, 8408a, 8408b located on the gripper member 8402. The end actuator 8400 comprises a gripper member 8402 and an ultrasonic blade 8404. The gripper member 8402 is shown holding tissue 8410 situated between the gripper member 8402 and the ultrasonic blade 8404. A first sensor 8406 is situated in a central portion of the gripper member 8402. The second and third sensors 8408a and 8408b are situated on side portions of the gripper member 8402. Sensors 8406, 8408a, 8408b are integrally mounted or formed with a flexible circuit 8412 (shown more particularly in Figure 52) configured to be fixedly mounted to the gripper member 8402.

[0525] End actuator 8400 is an exemplary end actuator for a surgical instrument. Sensors 8406, 8408a, 8408b are electrically connected to a control circuit such as control circuit 7400 (Figure 63) through interface circuits. Sensors 8406, 8408a, 8408b are battery powered and signals generated by sensors 8406, 8408a, 8408b are supplied to analog and/or digital processing circuits of the control circuit.

[0526] In one aspect, the first sensor 8406 is a force sensor for measuring a normal force F3 applied to tissue 8410 by the gripper member 8402. The second and third sensors 8408a, 8408b include one or more elements for applying force energy. RF to tissue 8410 measures tissue impedance, downward force F1, transverse forces F2, and temperature, among other parameters. Electrodes 8409a, 8409b are electrically coupled to a power source and apply RF energy to tissue 8410. In one aspect, the first sensor 8406 and the second and third sensors 8408a and 8408b are strain gauges for measuring force or force by area unit. It will be recognized that measurements of the downward force F1, the lateral forces F2 and the normal force F3 can be easily converted to pressure by determining the surface area on which the force sensors 8406, 8408a, 8408b are acting. Furthermore, as particularly described herein, the flexible circuit 8412 may comprise temperature sensors incorporated into one or more layers of the flexible circuit 8412. The one or more temperature sensors may be arranged symmetrically or asymmetrically, and provide temperature feedback. of fabric 8410 for control circuits of an ultrasonic drive circuit and an RF drive circuit.

[0527] Figure 52 illustrates an aspect of the flexible circuit 8412 shown in Figure 51, in which sensors 8406, 8408a, 8408b can be mounted thereon or integrally formed therewith. Flexible circuit 8412 is configured to securely connect to gripper member 8402. As shown particularly in Figure 52, asymmetric temperature sensors 8414a, 8414b are mounted on flexible circuit 8412 to enable measurement of the temperature of tissue 8410 (Figure 51).

[0528] Figure 53 is an alternative system 132000 for controlling the frequency of an ultrasonic electromechanical system 132002 and detecting the impedance thereof, in accordance with at least one aspect of the present description. The 132000 system can be incorporated into a generator. A processor 132004 coupled to a memory 132026 programs a programmable counter 132006 to tune to the output frequency of the ultrasonic electromechanical system 132002. The input frequency is generated by a crystal oscillator 132008 and is input to a fixed counter 132010 to scale the frequency to an appropriate value. The outputs of the fixed counter 132010 and the programmable counter 132006 are applied to a phase/frequency detector 132012. The output of the phase/frequency detector 132012 is applied to an amplifier/active filter circuit 132014 to generate a tuning voltage Vt that is applied to a 132016 voltage controlled oscillator (VCO). The VCO 132016 applies the output frequency fo to an ultrasonic transducer portion of the ultrasonic electromechanical system 132002, shown here modeled as an equivalent electrical circuit. The voltage and current signals applied to the ultrasonic transducer are monitored by a 132018 voltage sensor and a 132020 current sensor.

[0529] The outputs of voltage and current sensors 132018, 13020 are applied to another phase/frequency detector 132022 to determine the phase angle between voltage and current as measured by voltage and current sensors 132018, 13020. The output of the phase/frequency detector 132022 is applied to a channel of a high-speed analog-to-digital converter 132024 (ADC) and is provided to the processor 132004 therethrough. Optionally, the outputs of the voltage and current sensors 132018, 132020 may be applied to the respective channels of the two ADC channels 132024 and provided to the processor 132004 for zero crossing, FFT, or other algorithm described herein to determine the phase angle between the voltage and current signals applied to the ultrasonic electromechanical system 132002.

[0530] Optionally the tuning voltage Vt, which is proportional to the output frequency fo, may be fed back to the processor 132004 via the ADC 132024. This provides the processor 132004 with a feedback signal proportional to the output frequency fo and can use this feedback to adjust and control the fo output frequency.

Estimation of claw condition (block burn, staples, broken blade, bone in claw, tissue in claw)

[0531] A challenge with the application of ultrasonic energy is that ultrasonic acoustics applied to the incorrect materials or incorrect tissue can result in device failure, for example, burnout of the clamping arm block or breakage of the ultrasonic blade. It is also desirable to detect what is located in the jaws of an end actuator of an ultrasonic device and the state of the jaws without adding more sensors to the jaws. Positioning sensors in the jaws of an ultrasonic end actuator creates reliability, cost, and complexity challenges.

[0532] Smart blade algorithm techniques for ultrasonic spectroscopy can be employed to estimate the state of the gripper (grip arm block burnout, staples, broken blade, bone in the gripper, tissue in the gripper, clipping with the gripper closed, etc. ) based on impedance of an ultrasonic transducer configured to drive an ultrasonic transducer blade, in accordance with at least one aspect of the present description. The impedance Za(t), the magnitude |Z| and phase ^ are plotted as a function of frequency f.

[0533] Dynamic mechanical analysis (DMA), also known as dynamic mechanical spectroscopy or simply mechanical spectroscopy, is a technique used to study and characterize materials. A sinusoidal stress is applied to a material and the strain in the material is measured, making it possible to determine the complex modulus of the material. Spectroscopy as applied to ultrasonic devices includes exciting the tip of the ultrasonic blade with a sweep of frequencies (composite signals or traditional frequency sweeps) and measuring the resulting complex impedance at each frequency. Complex impedance measurements of the ultrasonic transducer over a range of frequencies are used in a classifier or model to infer the characteristics of the ultrasonic end actuator. In one aspect, the present disclosure provides a technique for determining the state of an ultrasonic end actuator (grip arm, gripper) to trigger automation in the ultrasonic device (e.g., disable power to secure the device, run adaptive algorithms, retrieve information, identify tissue, etc.).

[0534] Figure 54 is a 132030 spectrum of an ultrasonic device with several different end actuator states and conditions, wherein the impedance Zg(t), the magnitude |Z| and phase ^ are plotted as a function of frequency f, in accordance with at least one aspect of the present description. The 132030 spectrum is plotted in three-dimensional space where frequency (Hz) is plotted along the x axis, phase (Rad) is plotted along the y axis, and magnitude (Ohms) is plotted along the z axis.

[0535] Spectral analysis of different gripper bites and device states produces different characteristic complex impedance patterns (control points) over a range of frequencies for different conditions and states. Each state or condition has a different characteristic pattern in three-dimensional space when plotted. These characteristic patterns can be used to estimate the condition and state of the end actuator. Figure 54 shows the air spectrum 132032, the clamping arm block 132034, the chamois 132036, the staple 132038 and the broken blade 132040. The chamois 132036 can be used to characterize different types of fabric.

[0536] The 132030 spectrum can be evaluated by providing a low-power electrical signal across the ultrasonic transducer to produce a non-therapeutic excitation of the ultrasonic blade. The low power electrical signal can be provided in the form of a sweep or a composite Fourier series to measure impedance across the 5V Ig(t) ultrasonic transducer over a range of frequencies in series (sweep) or in parallel (composite signal) using an FFT.

New data classification methods

[0537] For each characteristic pattern, a parametric line may be fitted to the data used for training using a polynomial equation, a Fourier series equation, or any other form of parametric equation as may be directed for purposes of convenience. A new data point is then received and classified using the Euclidean perpendicular distance from the new data point to the trajectory that was fitted to the characteristic pattern training data. The perpendicular distance from the new data point to each of the trajectories (where each trajectory represents a different state or condition) is used to assign the point to a state or condition.

[0538] The probability distribution of distance from each point in the training data to the fitted curve can be used to estimate the probability of a correctly classified new data point. This essentially constructs a two-dimensional probability distribution in a plane perpendicular to the fitted trajectory at each new data point of the fitted trajectory. The new data point can then be included in the training set based on its probability of correct classification to create an adaptive learning classifier that readily detects high-frequency changes in states but adapts to slowly occurring deviations in performance. system, for example, a dirty device or block wear.

[0539] Figure 55 is a graphical representation of a 132042 plot of a three-dimensional training data set (S), wherein the impedance Zg(t), the magnitude |Z| and the phase ^ of the ultrasonic transducer are plotted as a function of frequency f, in accordance with at least one aspect of the present description. The plot of the three-dimensional training data set (S) 132042 is graphically represented in three-dimensional space where phase (Rad) is plotted along the x-axis, frequency (Hz) is plotted along the y-axis, magnitude (Ohms) is plotted along the geometric z axis and the parametric Fourier series is fitted to the three-dimensional training data set (S). A methodology for data classification is based on the three-dimensional training data set (S0 is used to generate the 132042 plot).

[0540] The parametric Fourier series fitted to the three-dimensional training data set (S) is given by:

[0541] To a new point , the perpendicular distance from until is found by: When: Then:

[0542] A probability distribution of D can be used to estimate the probability of a data point z belonging to group S.

Control

[0543] Based on the classification of data measured before, during, or after activation of the ultrasonic transducer/ultrasonic blade, various automated tasks and safety measurements can be implemented. Similarly, the state of the tissue located in the end actuator and the temperature of the ultrasonic blade can also be inferred to some extent and used to better inform the user about the state of the ultrasonic device or protect critical structures, etc. Temperature control of an ultrasonic blade is described in jointly owned provisional US patent application No. 62/640,417, filed March 8, 2018, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, which is incorporated herein by title reference in its entirety.

[0544] Similarly, power application may be reduced when there is a high probability that the ultrasonic blade will contact the clamping arm block (e.g., with no tissue between them) or if there is a probability that the ultrasonic blade has broken or the ultrasonic blade is touching metal (for example, a staple). Additionally, clipping may not be permitted if the gripper is closed and no tissue is detected between the ultrasonic blade and the clamping arm block.

Integration of other data to improve ranking

[0545] This system can be used with other information provided by sensors, by the user, by metrics on the patient, by environmental factors, etc., by combining the data from this process with the previously mentioned data using probability functions and a Kalman filter. The Kalman filter determines the maximum probability of a state or condition occurring given an infinite number of uncertain measurements of varying confidence. Since this method enables a probability assignment to a newly classified data point, the information from this algorithm can be implemented with other measurements or estimates in a Kalman filter.

[0546] Figure 56 is a logic flow diagram 132044 depicting a control program or logic configuration for determining gripper conditions based on the characteristic complex impedance pattern (control point), in accordance with at least one aspect of the this description. Before determining clamp conditions based on the complex impedance characteristic pattern (control point), a database is fed with reference complex impedance characteristic patterns or training data sets (S) that characterize various clamp conditions. claw, including, without limitation, the air 132032, the grip arm block 132034, the chamois 132036, the clamp 132038, the broken blade 132040, as shown in Figure 82, and various types and conditions of fabric. Dry or wet suede, with full or tip bite, can be used to characterize different types of fabric. The data points used to generate reference complex impedance characteristic patterns or a training data set (S) are obtained by providing a subtherapeutic drive signal to the ultrasonic transducer and sweeping the drive frequency over a range predetermined range of frequencies from below resonance to above resonance, measuring the complex impedance at each frequency and recording the data points. The data points are then fitted to a curve using various numerical methods that include polynomial curve fitting, Fourier series, and/or parametric equation. A parametric Fourier series fit to reference complex impedance characteristic patterns or to a training data set (S) is described herein.

[0547] Once the reference complex impedance characteristic patterns or training data sets (S) are generated, the ultrasonic instrument measures the new data points, classifies the new points, and determines whether the new data points should be added to the reference complex impedance characteristic patterns or training data sets (S).

[0548] Referring now to the logic flow diagram of Figure 56, in one aspect, the processor or control circuit measures 132046 a complex impedance of an ultrasonic transducer, wherein the complex impedance is defined as The processor or control circuit receives 132048 a complex impedance measurement data point and compares 132050 the complex impedance measurement data point with a data point in a reference complex impedance characteristic pattern. The processor or control circuit classifies 132052 the complex impedance measurement data point based on a result of the comparison analysis and assigns 132054 a state or condition of the end actuator based on the result of the comparison analysis.

[0549] In one aspect, the processor or control circuit receives the characteristic reference complex impedance pattern from a database or memory coupled to the processor. In one aspect, the processor or control circuit generates the characteristic reference complex impedance pattern as follows. A drive circuit coupled to the processor or control circuit provides a non-therapeutic drive signal to the ultrasonic transducer starting at an initial frequency, ending at an end frequency, and a plurality of frequencies in between. The processor or control circuit measures the impedance of the ultrasonic transducer at each frequency and stores a data point corresponding to each impedance measurement. The processor or control circuit curve fits a plurality of data points to generate a three-dimensional curve representative of the reference complex impedance characteristic pattern, where the magnitude |Z| and phase <p are plotted as a function of frequency f. Curve fitting includes a polynomial curve fit, a Fourier series, and/or a parametric equation.

[0550] In one aspect, the processor or control circuit receives a new impedance measurement data point and classifies the new impedance measurement data point using a perpendicular Euclidean distance from the new impedance measurement data point to a trajectory that has been fitted to the reference complex impedance characteristic pattern. The processor or control circuit estimates a probability that the new impedance measurement data point is correctly classified. The processor or control circuit adds the new impedance measurement data point to the reference complex impedance characteristic pattern based on the estimated correct classification probability of the new impedance measurement data point. In one aspect, the processor or control circuit classifies data based on a training data set (S), wherein the training data set (S) comprises a plurality of complex impedance measurement data, and the curve fits the training data set (S) using a parametric Fourier series, where S is defined here and where the probability distribution is used to estimate the probability that the new impedance measurement data point belongs to the group S .

Grip classifier state based on model

[0551] There has been interest in classifying matter within the jaws of an ultrasonic device including tissue types and condition. In several respects, it can be shown that with high data sampling and sophisticated pattern recognition, such classification is possible. The approach is based on impedance as a function of frequency, where magnitude, phase, and frequency are plotted three-dimensionally and the patterns look like ribbons, as shown in Figures 54 and 55 and the logic flow diagram in Figure 56. This description provides an alternative smart blade algorithm approach that is based on a well-established model for piezoelectric transducers.

[0552] By way of example, the equivalent electrical lumped parameter model is known to be an accurate model of the physical piezoelectric transducer. It is based on the Mittag-Leffler expansion of a tangent near a mechanical resonance. When complex impedance or complex admittance is plotted as an imaginary component versus a real component, circles are formed. Figure 57 is a circle plot 132056 of complex impedance plotted as an imaginary component versus real components of a piezoelectric vibrator, in accordance with at least one aspect of the present description. Figure 58 is a circle plot 132058 of complex admittance plotted as an imaginary component versus real components of a piezoelectric vibrator, in accordance with at least one aspect of the present description. The circles represented in Figures 57 and 58 are taken from the IEEE 177 standard, which is incorporated herein by reference in its entirety. Tables 1 through 4 are taken from the IEEE 177 standard and described here for completeness.

[0553] The circle is created as the frequency is swept from below resonance to above resonance. Instead of stretching the circle in 3D, a circle is identified and the radius (r) and displacements (a, b) of the circle are estimated. These values are then compared with values established for certain conditions. These conditions can be: 1) open, nothing in the claws, 2) tip bite 3) full bite and clamp in the claws. If the scan generates multiple resonances, circles of different characteristics will be present for each resonance. Each circle will be extended before the next if the resonances are separated. Instead of fitting a 3D curve with a series approximation, the data is fitted with a circle. The radius (r) and displacements (a, b) can be calculated using a processor programmed to perform various mathematical or numerical techniques described below. These values can be estimated by capturing an image of a circle and, using image processing techniques, the radius (r) and displacements (a, b) that define the circle are estimated.

[0554] Figure 59 is a circle plot 132060 of the complex admittance for a 55.5 kHz ultrasonic piezoelectric transducer for grouped parameter inputs and outputs specified below. Values from a grouped parameter model were used to generate the complex admittance. A moderate load was applied to the model. The obtained admittance circle generated in MathCad is shown in Figure 59. The circle plot 132060 is formed when the frequency is swept from 54 to 58 kHz.

[0555] Grouped parameter input values are:

[0556] The model outputs based on the inputs are:

[0557] The output values are used to plot the circle plot 132060 shown in Figure 59. The circle plot 132060 has a radius (r) and the center 132062 is offset (a, b) from the origin 132064 as follows:

[0558] The AE sums specified below are necessary to estimate the circle plot 132060 for the example given in Figure 59, in accordance with at least one aspect of the present description. There are several algorithms for calculating a fit to a circle. A circle is defined by its radius (r) and the displacements (a, b) of the center from the origin:

[0559] The modified least squares method (Umbach and Jones) is convenient as there is a simple solution formed nearby for a, b and r.

[0560] The caret over the variable "a" indicates an estimate of the actual value. A, B, C, D and E are sums of several products that are calculated from the data. They are included in the present invention for completeness as follows: Z1,i is a first vector of real components called conductance; Z2,i is a second of imaginary components called susceptance; and Z3,i is a third vector representing the frequencies at which the admittances are calculated.

[0561] The present description will work for ultrasonic systems and can possibly be applied to electrosurgical systems, although electrosurgical systems do not depend on a resonance.

[0562] Figures 60 to 64 illustrate images taken from an impedance analyzer showing impedance/admittance circle plots for an ultrasonic device with the end actuator claw in various open or closed and loading configurations. Solid line circle plots illustrate impedance and dashed line circle plots illustrate admittance, in accordance with at least one aspect of the present description. By way of example, impedance/admittance circle plots are generated by connecting an ultrasonic device to an impedance analyzer. The impedance analyzer screen is configured in complex impedance and complex admittance, which can be selectable from the front panel of the impedance analyzer. A home screen can be obtained with the ultrasonic end actuator claw in an open position and the ultrasonic device in an uncharged state, as described below in relation to Figure 60, for example. The impedance analyzer's autoscale display function can be used to generate both complex impedance and admittance circle plots. The same screen is used for subsequent uses of the ultrasonic device with different loading conditions, as shown in subsequent Figures 60 to 64. A LabVIEW application can be used to upload the data files. In another technique, screen images can be captured with a camera, for example, a smartphone camera such as an iPhone or Android. Therefore, the screen image may include some "keystone effect" and may not generally appear parallel to the screen. Using this technique, the circle plot traces on the screen will appear distorted in the captured image. With this approach, the material located in the jaws of the ultrasonic end actuator can be classified.

[0563] Complex impedance and complex admittance are reciprocal only of each other. No new information should be added by looking at both. Another consideration includes determining how sensitive the estimates are to noise when using complex impedance or complex admittance.

[0564] In the examples illustrated in Figures 60 to 64, the impedance analyzer is configured with a variation to capture only the main resonance. By scanning a wider range of frequencies, more resonances can be found and multiple circle plots can be formed. An equivalent circuit of an ultrasonic transducer can be modeled by a first "motion" branch having, serially connected, the inductance Ls, the resistance Rs and the capacitance Cs that define the electromechanical properties of the resonator, and a second capacitive branch having a capacitance static C0. In the impedance/admittance plots shown in Figures 60 to 64 below, the values of the equivalent circuit components are:

[0565] The oscillator voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance scale (Z) is 200 Q/div and the admittance scale (Y) is 500 μS/div. Measurements of values that can characterize the impedance (Z) and admittance (Y) circle plots can be obtained at the locations on the circle plots as indicated by an impedance cursor and an admittance cursor.

Clamp status: Open without loading

[0566] Figure 60 is a graphical display 132066 of an impedance analyzer showing complex impedance (Z)/admittance (Y) circle plots 132068, 132070 for an ultrasonic device with the jaw open and unloaded, wherein a plot circle plot 132068 in solid line represents complex impedance and a circle plot 132070 in dashed line represents complex admittance, in accordance with at least one aspect of the present description. The oscillator voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance scale (Z) is 200 Q/div and the admittance scale (Y) is 500 μS/div. Measurements of values that can characterize the complex impedance (Z) and admittance (Y) circle plots 132068, 132070 can be obtained at locations on the circle plots 132068, 132070 as indicated by the impedance cursor 132072 and the admittance cursor 132074. Thus, the impedance cursor 132072 is situated on a portion of the impedance circle plot 132068 that is equivalent to about 55.55 kHz and the admittance cursor 132074 is situated on a portion of the admittance circle plot 132070 which is equivalent to about 55.29 kHz. As depicted in Figure 60, the position of the 132072 impedance cursor corresponds to values of: where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the position of the admittance cursor 132074 corresponds to values of: where G is the conductance (real value) and B is the susceptance (imaginary value).

Claw condition: Fastened in dry suede

[0567] Figure 61 is a graphical display 132076 of an impedance analyzer showing complex impedance (Z)/admittance (Y) circle plots 132078, 132080 for an ultrasonic device with the end actuator claw secured in dry suede, wherein the impedance circle plot 132078 is shown as a solid line and the admittance circle plot 132080 is shown as a dashed line, in accordance with at least one aspect of the present description. The voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance scale (Z) is 200 Q/div and the admittance scale (Y) is 500 μS/div.

[0568] Measurements of values that can characterize complex impedance (Z) and admittance (Y) circle plots 132078, 132080 can be obtained at locations on circle plots 132078, 132080 as indicated by the impedance cursor 132082 and the admittance cursor 132084. Thus, impedance cursor 132082 is situated on a portion of the 132078 impedance circle plot that is equivalent to about 55.68 kHz and admittance cursor 132084 is situated on a portion of the circle plot of admittance 132080 which is equivalent to about 55.29 kHz. As depicted in Figure 61, the position of the 132082 impedance cursor corresponds to values of: where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the position of the admittance cursor 132084 corresponds to values of: where G is the conductance (real value) and B is the susceptance (imaginary value).

Claw condition: Tip stuck in damp suede

[0569] Figure 62 is a graphical display 132086 of an impedance analyzer showing complex impedance (Z)/admittance (Y) circle plots 132098, 132090 for an ultrasonic device with the claw tip clamped in damp suede, where the impedance circle plot 132088 is shown in solid line and admittance circle plot 132090 is shown in dashed line, in accordance with at least one aspect of the present description. The voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance scale (Z) is 200 Q/div and the admittance scale (Y) is 500 μS/div.

[0570] Measurements of values that can characterize the complex impedance (Z) and complex admittance (Y) circle plots 132088, 132090 can be obtained at locations in the circle plots 132088, 132090 as indicated by the impedance cursor 132092 and by the admittance cursor 132094. Thus, the impedance cursor 132092 is situated on a portion of the impedance circle plot 132088 that is equivalent to about 55.68 kHz and the admittance cursor 132094 is situated on a portion of the plot at admittance circle 132090 which is equivalent to about 55.29 kHz. As depicted in Figure 63, the 132092 impedance cursor corresponds to values of: where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the admittance cursor 132094 corresponds to values of: where G is the conductance (real value) and B is the susceptance (imaginary value).

Claw condition: Completely secured in damp suede

[0571] Figure 63 is a graphical display 132096 of an impedance analyzer showing complex impedance (Z)/admittance (Y) circle plots 132098, 132100 for an ultrasonic device with the claw completely secured in damp suede, where the plot circle plot of impedance 132098 is shown as a solid line and circle plot of admittance 132100 is shown as dashed line, in accordance with at least one aspect of the present description. The voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance scale (Z) is 200 Q/div and the admittance scale (Y) is 500 μS/div.

[0572] Measurements of values that can characterize the impedance and admittance circle plots 132098, 132100 can be obtained at locations on the circle plots 132098, 1332100 as indicated by the impedance cursor 13212 and the admittance cursor 132104. In this way , the impedance cursor 132102 is located on a portion of the impedance circle plot 132098 equivalent to about 55.63 kHz and the admittance cursor 132104 is located on a portion of the admittance circle plot 132100 equivalent to about 55. 29 kHz. As depicted in Figure 63, the 132102 impedance cursor corresponds to values of R, the resistance (real value, not shown) and X, the reactance (imaginary value, also not shown).

[0573] Similarly, admittance cursor 132104 corresponds to values of: where G is the conductance (real value) and B is the susceptance (imaginary value).

Clamp status: Open without loading

[0574] Figure 64 is a graphical display 132106 of an impedance analyzer showing impedance (Z)/admittance (Y) circle plots, where the frequency is swept from 48 kHz to 62 kHz to capture multiple resonances of a ultrasonic device with the jaw open and unloaded, wherein the area designated by the rectangle 132108, shown in dashed line, serves to help visualize the impedance circle plots 132110a, 132110b, 132110c shown in solid line and the impedance circle plots 132110a, 132110b, 132110c shown in solid line and the impedance circle plots admittance 132112a, 132112b, 132112c, in accordance with at least one aspect of the present description. The voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 48 kHz to 62 kHz. The impedance scale (Z) is 500 Q/div and the admittance scale (Y) is 500 μS/div.

[0575] Measurements of values that can characterize the impedance and admittance circle plots 132110a-c, 132112a-c can be obtained at locations on the impedance and admittance circle plots 132110a-c, 132112a-c as indicated by impedance cursor 132114 and admittance cursor 132116. Thus, impedance cursor 132114 is located on a portion of the impedance circle plots 132110a-c equivalent to about 55.52 kHz and admittance cursor 132116 is located on a portion of the admittance circle plot 132112a-c equivalent to about 59.55 kHz. As depicted in Figure 64, the 132114 impedance cursor corresponds to values of: where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the admittance cursor 132116 corresponds to values of: where G is the conductance (real value) and B is the susceptance (imaginary value).

[0576] Since there are only 400 samples throughout the sweep range of the impedance analyzer, there are only a few points on a resonance. Then the circle on the right side becomes agitated. However, this is only due to the impedance analyzer and the settings used to cover multiple resonances.

[0577] When multiple resonances are present, there is more information to improve the classifier. The fit of circle plots 132110a-c, 132112a-c can be calculated for each as it is found to keep the algorithm running quickly. Then, since there is a crossing of the complex admittance, which implies a circle, during the scan, a fit can be calculated.

[0578] Benefits include the data-driven in-clamp classifier and a well-known model of ultrasonic systems. Circle counts and characterizations are well known in vision systems. So data processing is readily available. For example, there is a closed-form solution to calculate the radius and axis offsets for a circle. This technique can be relatively quick.

[0579] Table 2 is a list of symbols used for the grouped parameter model of a piezoelectric transducer (from the IEEE 177 standard). Table 2

[0580] Table 3 is a list of symbols for the transmission network (from the IEEE 177 standard). Table 3

[0581] Table 4 is a list of solutions for various characteristic frequencies (from the IEEE 177 standard). SOLUTIONS FOR VARIOUS FREQUENCIES CHARACTERISTICS Table 4

[0582] Table 5 is a list of losses of three classes of piezoelectric materials. Minimum values for the Qr/ra ratio to be expected for different types of piezoelectric vibrators Table 5

[0583] Table 6 illustrates gripper conditions, estimated parameters of a circle based on real-time measurements of complex impedance/admittance, radius (re) and displacements (ae and be) of the circle represented by measured variables Re, Ge, reference represented by the reference variables Rref, Gref, Xref, Bref. These values are thus compared with values established for certain conditions. These conditions can be: 1) open, nothing in the claws, 2) tip bite 3) full bite and clamp in the claws. The equivalent circuit of the ultrasonic transducer was modeled as follows and the frequency was swept from 55 kHz to 56 kHz: Table 6

[0584] In use, ultrasonic generators perform frequency sweeps, record measured variables and determine Re, Ge, Xe, Be estimates. These estimates are then compared to the reference variables Rref, Gref, Xref, Bref stored in memory (e.g. stored in a lookup table) and determine the gripper conditions. The gripper reference conditions shown in Table 6 are examples only. More or less gripper reference conditions can be classified and stored in memory. These variables can be used to estimate the radius and displacements of the impedance/admittance circle.

[0585] Figure 65 is a logic flow diagram 132120 of a process representing a control program or logic configuration for determining gripper conditions based on estimates of the radius (r) and displacements (a, b) of a impedance/admittance circle, in accordance with at least one aspect of the present description. Initially, a database or lookup table is fed with reference values based on gripper reference conditions as described in relation to Figures 60 to 64 and Table 6. A gripper reference condition is defined and the frequency is scanned from a value below resonance to a value above resonance. The Rref, Gref, Xref, Bref reference values that define the corresponding impedance/admittance circle plot are stored in a database or lookup table. During use, under the control of a control program or logic configuration, a processor or control circuit of the generator or instrument causes the frequency to sweep 132122 from below resonance to above resonance. The processor or control circuit measures and records 132124 (i.e. stores in memory) the variables Re, Ge, Xe, Be that define the corresponding impedance/admittance circle plot and compares them 132126 with the reference values Rref, Gref , Xref, Bref stored in the database or lookup table. The processor or control circuit determines 132128, for example estimates, the conditions of the end actuator claw based on the results of the comparison.

Temperature Inference

[0586] Figures 66A and 66B are graphical representations 133000, 133010 of complex impedance spectra of the same ultrasonic device with a cold (room temperature) and hot ultrasonic blade, in accordance with at least one aspect of the present description. As used in the present invention, a cold ultrasonic blade refers to an ultrasonic blade at room temperature and a hot ultrasonic blade refers to an ultrasonic blade after it is heated by friction during use. Figure 66A is a plot 133000 of the impedance phase angle Φ as a function of resonance frequency fo of the same ultrasonic device with a cold and hot ultrasonic blade and Figure 66B is a plot 133010 of impedance magnitude |Z| as a function of the resonance frequency fo the same ultrasonic device with a cold and hot ultrasonic blade. The impedance phase angle Φ and the impedance magnitude |Z| are at least at the resonance frequency fo.

[0587] The ultrasonic transducer impedance Zg(t) can be measured as the ratio between the generator voltage drive signals Vg(t) and generator current Ig(t):

[0588] As shown in Figure 66A, when the ultrasonic blade is cool, for example, at room temperature and not heated by friction, the resonant electromechanical frequency of the ultrasonic device is approximately 55,500 Hz and the excitation frequency of the ultrasonic transducer is set at 55,500 Hz. Thus, when the ultrasonic transducer is excited at the resonant electromechanical frequency fo and the ultrasonic blade is cold, the phase angle Φ is at least or approximately 0 Rad as indicated by the cold blade plot 133002. As shown in Figure 66B, when the ultrasonic blade is cold and the ultrasonic transducer is excited at the resonant electromechanical frequency fo, the impedance magnitude |Z| is 800 Q, for example, the impedance magnitude |Z| is at an impedance minimum and the drive signal amplitude is at a maximum due to the series resonance equivalent circuit of the ultrasonic electromechanical system as depicted in Figure 25.

[0589] Referring now again to Figures 66A and 66B, when the ultrasonic transducer is driven by generator voltage signals Vg(t) and generator current signals Ig(t) at the resonant electromechanical frequency of 55,500 Hz, the angle phase Φ between the generator voltage signals Vg(t) and the generator current Ig(t) is equal to zero, the impedance magnitude |Z| is at an impedance minimum, for example, 800 Q, and the signal amplitude is at a peak or maximum due to the series resonance equivalent circuit of the ultrasonic electromechanical system. As the temperature of the ultrasonic blade increases, due to the frictional heat generated in use, the resonant electromechanical frequency fo' of the ultrasonic device decreases. Since the ultrasonic transducer is still driven by the generator voltage signals Vg(t) and generator current signals Ig(t) at the previous resonant electromechanical frequency (cold blade) fo 55,500 Hz, the ultrasonic device operates out of resonance fo ' causing a shift in the phase angle Φ between the generator voltage signals Vg(t) and the generator current signals Ig(t). There is also an increase in the impedance magnitude |Z| and a drop in the peak magnitude of the drive signal relative to the previous electromechanical resonant (cold blade) frequency of 55,500 Hz. Consequently, the temperature of the ultrasonic blade can be inferred by measuring the phase angle Φ between the voltage signals of the generator Vg(t) and generator current Ig(t) when the resonant electromechanical frequency fo changes due to changes in the temperature of the ultrasonic blade.

[0590] As previously described, an electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide, and an ultrasonic blade. As previously discussed, the ultrasonic transducer can be modeled as an equivalent series resonant circuit (see Figure 25) that comprises a first branch having a static capacitance and a second "moving" branch having a series-connected inductance, resistance, and capacitance that define the electromechanical properties of a resonator. The electromechanical ultrasonic system has an initial electromechanical resonance frequency defined by the physical properties of the ultrasonic transducer, the waveguide, and the ultrasonic blade. The ultrasonic transducer is excited by an alternating voltage signal Vg(t) and current Ig(t) at a frequency equal to the electromechanical resonance frequency, for example, the resonance frequency of the electromechanical ultrasonic system. When the electromechanical ultrasonic system is excited at the resonance frequency, the phase angle Φ between the voltage signals Vg(t) and current Ig(t) is zero.

[0591] In other words, at resonance, the analog inductive impedance of the electromechanical ultrasonic system is equal to the analog capacitive impedance of the electromechanical ultrasonic system. As the ultrasonic blade heats up, for example due to frictional engagement with tissue, the compliance of the ultrasonic blade (modeled as an analog capacitance) causes the resonant frequency of the electromechanical ultrasonic system to change. In the present example, the resonance frequency of the electromechanical ultrasonic system decreases as the temperature of the ultrasonic blade increases. Therefore, the analog inductive impedance of the electromechanical ultrasonic system is no longer equal to the analog capacitive impedance of the electromechanical ultrasonic system, causing a mismatch between the drive frequency and the new resonance frequency of the electromechanical ultrasonic system. In this way, with a hot ultrasonic blade, the electromechanical ultrasonic system operates "out of resonance". The difference between the drive frequency and the resonance frequency is manifested as a phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer.

[0592] As previously discussed, the electronic circuit of the generator can easily monitor the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer. The phase angle Φ can be determined through Fourier analysis, weighted least squares estimation, Kalman filtration, vector space-based techniques, zero crossing method, Lissajous figures, three voltmeter method, crossed-coil method ", vector voltmeter and vector impedance methods, standard phase instruments, phase-locked loops and other previously described techniques. The generator can continuously monitor the phase angle Φ and adjust the drive frequency until the phase angle Φ becomes zero. At this point, the new drive frequency is equal to the resonant frequency of the new electromechanical ultrasonic system. The change in phase angle Φ and/or generator drive frequency can be used as an indirect or inferred measurement of the temperature of the ultrasonic blade.

[0593] A variety of techniques are available to estimate temperature from data in these spectra. Most notably, a nonlinear, time-varying set of state space equations can be used to model the dynamic relationship between the temperature of the ultrasonic blade and the measured impedance: across a range of generator drive frequencies, wherein the range of generator drive frequencies is specific to the device model.

Temperature estimation methods

[0594] One aspect of estimating or inferring the temperature of an ultrasonic blade may include three steps. First, define a temperature and frequency state space model that is time and energy dependent. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between the electromechanical resonance frequency and the temperature of the ultrasonic blade. Second, apply a Kalman filter to improve the accuracy of the temperature estimator and the state space model over time. Third, a state estimator is provided in the Kalman filter feedback circuit to control the power applied to the ultrasonic transducer, and consequently the ultrasonic blade, to regulate the temperature of the ultrasonic blade. The three steps are described later in this document.

Step 1

[0595] The first step is to define a temperature and frequency state space model that is time and energy dependent. To model temperature as a function of frequency content, a set of nonlinear state space equations are used to model the relationship between the electromechanical resonance frequency and the temperature of the ultrasonic blade. In one aspect, the state space model is given by:

[0596] The state space model represents the rate of change of the natural frequency of the electromechanical ultrasonic system Fn and the rate of change of the temperature t of the ultrasonic blade with respect to the natural frequency Fn(t), temperature T(t), energy F(t), and time t. y represents the observability of variables that are measurable and observable, such as the natural frequency Fn(t) of the electromechanical ultrasonic system, the temperature T(t) of the ultrasonic blade, the energy F(t) applied to the ultrasonic blade, and the time t. The temperature T(t) of the ultrasonic blade is observable as an estimate.

Step 2

[0597] The second step is to apply a Kalman filter to improve the temperature estimator and the state space model. Figure 67 is a diagram of a 133020 Kalman filter to improve the temperature estimator and the state space model based on impedance according to the equation: which represents the impedance across an ultrasonic transducer measured at a variety of frequencies, in accordance with at least one aspect of the present description.

[0598] The Kalman filter 133020 can be used to improve temperature estimation performance and allows augmentation of external sensors, models, or prior information to improve temperature prediction amid noisy data. The 133020 Kalman filter includes a 133022 regulator and a 133024 plant. In control theory, a 133024 plant is the combination of process and actuator. A plant 133024 can be called a transfer function that indicates the relationship between an input signal and the output signal of a system. The regulator 133022 includes a status estimator 133026 and a K controller 133028. The status regulator 133026 includes a feedback circuit 133030. The status regulator 133026 receives y, the plant output 133024, as an input and a feedback variable u . The 133026 state estimator is an internal feedback system that converges to the true value of the system state. The output of the 133026 state estimator is x, the complete feedback control variable including Fn(t) of the electromechanical ultrasonic system, the temperature estimate T(t) of the ultrasonic blade, the energy F(t) applied to the ultrasonic blade, the phase angle Φ, and the time t. The input into the K 133028 controller is x and the output of the K 133028 controller u is fed back to the state estimator 133026 and t of the plant 133024.

[0599] Kalman filtration, also known as linear quadratic estimation (LQE), is an algorithm that uses a series of observed measurements over time, containing noise and other statistical inaccuracies, and produces estimates of unknown variables that tend to be more more accurate than those based on a single measurement only, by estimating a joint probability distribution over the variables for each time period and thus calculating the maximum likelihood estimate of actual measurements. The algorithm works in a two-step process. In a prediction step, the 133020 Kalman filter produces estimates of the current state variables along with their uncertainties. After the result of the next measurement (necessarily corrupted with some amount of error, including random noise) is observed, these estimates are updated using a weighted average, with more weight being given to estimates with greater certainty. The algorithm is recursive and can be executed in real time, using only the present input measurements and the previously calculated state and its uncertainty matrix; no additional information is required.

[0600] The 133020 Kalman filter uses a dynamic model of the electromechanical ultrasonic system, known control inputs for that system, and multiple sequential measurements (observations) of the natural frequency and phase angle of applied signals (e.g., impedance magnitude and phase of the ultrasonic transducer) to the ultrasonic transducer to form an estimate of the electromechanical ultrasonic system's varying quantities (its state) to predict the temperature of the ultrasonic blade portion of the electromechanical ultrasonic system that is better than an estimate obtained using only one single measurement only. As such, the 133020 Kalman filter is an algorithm that includes sensor and data fusion to provide the maximum likelihood estimate of the temperature of the ultrasonic blade.

[0601] The Kalman filter 133020 effectively estimates uncertainty due to noise measurements of signals applied to the ultrasonic transducer to measure natural frequency and phase shift data, and also effectively estimates uncertainty due to external random factors. The 133020 Kalman filter produces an estimate of the state of the electromechanical ultrasonic system as a weighted average of the predicted state of the system and the new measurement. Weighted values provide better (i.e., lower) estimated uncertainty and are more "reliable" than unweighted values. Weights can be calculated from covariance, a measure of the estimated uncertainty of predicting the state of the system. The result of the weighted average is a new estimate of the state that lies between the predicted and measured state, and has a better estimated uncertainty than either alone. This process is repeated at each time step, with the new estimate and its covariance generating the prediction used in the next iteration. This recursive nature of the 133020 Kalman filter requires only the last "best guess", rather than the entire history, of the state of the electromechanical ultrasonic system to calculate a new state.

[0602] The relative certainty of measurements and estimation of the current state is an important consideration, and it is common to discuss the filter response in terms of the K gain of the Kalman filter 133020. The Kalman gain K is the relative weight assigned to the measurements and estimation of current state, and can be "tuned" to achieve specific performance. With a high K gain, the 133020 Kalman filter places more weight on the most recent measurements, and thus tracks them more responsively. With a low gain K, the 133020 Kalman filter more closely follows the model predictions. From both extremes, a high gain close to one will result in a more irregular estimated trajectory, while a low gain close to zero will flatten the noise but decrease responsiveness.

[0603] When performing the actual calculations for the Kalman filter 133020 (as discussed below), the state estimate and covariances are encoded in covariance matrices to handle the multiple dimensions involved in a single set of calculations. This allows a representation of linear relationships between variables of different states (such as position, velocity, and acceleration) in any of the models or transition covariances. Using a 133020 Kalman filter does not assume that errors are Gaussian. However, the Kalman filter 133020 produces the exact conditional probability estimate in the special case that all errors are Gaussian distributed.

Step 3

[0604] The third step uses an estimator 133026 in the feedback state 133032 of the Kalman filter 133020 to control the power applied to the ultrasonic transducer, and consequently the ultrasonic blade, to regulate the temperature of the ultrasonic blade.

[0605] Figure 68 is a graphical representation 133040 of three probability distributions employed by a state estimator 133026 of the Kalman filter 133020 shown in Figure 67 to maximize estimates, in accordance with at least one aspect of the present description. The probability distributions include the prior probability distribution 133042, the prediction (state) probability distribution 133044, and the observation probability distribution 133046. The three probability distributions 133042, 133044, 1330467 are used in a power feedback control applied to an ultrasonic transducer to regulate temperature based on impedance across the ultrasonic transducer measured at a variety of frequencies, in accordance with at least one aspect of the present disclosure. The estimator used in the feedback control of the power applied to an ultrasonic transducer to regulate the temperature based on the impedance is given by the expression: which is the impedance across the ultrasonic transducer measured at a variety of frequencies, in accordance with at least one aspect of the present description.

[0606] Prior probability distribution 133042 includes a state variation defined by the expression:

[0607] The state variance is used to predict the next state of the system, which is represented as the prediction probability distribution (state) 133044. The observation probability distribution 133046 is the probability distribution of the actual observation of the system state where the observation variance am is used to define the gain, which is given by the following expression:

Feedback Control Circuit

[0608] The power input is decreased to ensure that the temperature (as estimated by the state estimator and the Kalman filter) is controlled.

[0609] In one aspect, the first proof of concept assumed a static linear relationship between the natural frequency of the electromechanical ultrasonic system and the temperature of the ultrasonic blade. By reducing the power as a function of the natural frequency of the electromechanical ultrasonic system (i.e., temperature regulation with feedback control), the temperature of the tip of the ultrasonic blade can be directly controlled. In this example, the temperature of the distal tip of the ultrasonic blade can be controlled so that it does not exceed the melting point of the Teflon block.

[0610] Figure 69A is a graphical representation 133050 of temperature versus time of an ultrasonic device without temperature feedback control. The temperature (°C) of the ultrasonic blade is shown along the vertical axis and the time (s) is shown along the horizontal axis. The test was conducted with a chamois located in the jaws of the ultrasonic device. One claw is the ultrasonic blade and the other claw is the clamping arm with a Teflon block. The ultrasonic blade was excited at the resonant frequency while in frictional engagement with the chamois clamped between the ultrasonic blade and the clamping arm. Over time, the temperature (°C) of the ultrasonic blade increases due to frictional engagement with the chamois. Over time, the temperature profile 133052 of the ultrasonic blade increases until the suede sample is cut after about 19.5 seconds at a temperature of 220°C as indicated in point 133054. Without temperature feedback control, after the cutting the suede sample, the temperature of the ultrasonic blade increases to a temperature well above the melting point of Teflon ~380°C to ~490°C. At point 133056, the temperature of the ultrasonic blade reaches a maximum temperature of 490°C until the Teflon block is completely melted. The temperature of the ultrasonic blade drops slightly from the peak temperature at point 133056 after the block disappears completely.

[0611] Figure 69B is a graph of temperature versus time of an ultrasonic device with temperature feedback control, in accordance with at least one aspect of the present description. The temperature (°C) of the ultrasonic blade is shown along the vertical axis and the time (s) is shown along the horizontal axis. The test was conducted with a chamois sample located in the jaws of the ultrasonic device. One claw is the ultrasonic blade and the other claw is the clamping arm with a Teflon block. The ultrasonic blade was excited at the resonant frequency while in frictional engagement with the chamois clamped between the ultrasonic blade and the clamping arm block. Over time, the temperature profile 133062 of the ultrasonic blade increases until the suede sample is cut after about 23 seconds at a temperature of 220°C as indicated in point 133064. With temperature feedback control, the blade temperature ultrasonic temperature rises to a maximum temperature of about 380°C, just below the melting point of TEFLON, as indicated in point 133066 and is then lowered to an average of about 330°C as indicated generally in region 133068, thus preventing melting of the TEFLON block.

Application of intelligent ultrasonic blade technology

[0612] When an ultrasonic blade is immersed in a surgical field filled with fluid, the ultrasonic blade cools during activation and becomes less effective in sealing and cutting the tissue in contact with it. Cooling the ultrasonic blade may lead to longer activation times and/or hemostasis problems because adequate heat is not applied to the tissue. To overcome ultrasonic blade cooling, more energy application may be required to shorten transection times and achieve adequate hemostasis under these fluid immersion conditions. With the use of a frequency-temperature feedback control system, if the temperature of the ultrasonic blade is detected to start below, or remain below a certain temperature for a certain period of time, the generator output power can be increased to compensate for cooling due to blood/saline/other fluid present in the surgical field.

[0613] Consequently, the temperature-frequency feedback control system described herein can optimize the performance of an ultrasonic device especially when the ultrasonic blade is situated or immersed, partially or fully, in a fluid-filled surgical field. The frequency-temperature feedback control system described here minimizes long activation times and/or potential problems with the performance of the ultrasonic device in the fluid-filled surgical field.

[0614] As previously described, the temperature of the ultrasonic blade can be inferred by detecting the impedance of the ultrasonic transducer given by the following expression: or equivalently, the detection of the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer. The phase angle information Φ can also be used to infer the conditions of the ultrasonic blade. As discussed in particular here, the phase angle Φ changes as a function of the temperature of the ultrasonic blade. Therefore, the phase angle information Φ can be used to control the temperature of the ultrasonic blade. This can be done, for example, by reducing the power supplied to the ultrasonic blade when the ultrasonic blade is too hot and by increasing the power applied to the ultrasonic blade when the ultrasonic blade is too cold. Figures 70A and 70B are graphical representations of temperature feedback control to adjust ultrasonic energy applied to an ultrasonic transducer when a sudden drop in temperature of an ultrasonic blade is detected.

[0615] Figure 70A is a graphical representation of the ultrasonic energy output 133070 as a function of time, in accordance with at least one aspect of the present description. The power output of the ultrasonic generator is shown along the vertical axis and the time (s) is shown along the horizontal axis. Figure 70B is a graphical representation of temperature of ultrasonic blade 133080 as a function of time, in accordance with at least one aspect of the present description. The temperature of the ultrasonic blade is shown along the vertical axis and the time (s) is shown along the horizontal geometric axis. The temperature of the ultrasonic blade increases with the application of constant power 133072 as shown in Figure 70A. During use, the temperature of the ultrasonic blade drops suddenly. This can result from a variety of conditions, however, during use it can be inferred that the temperature of the ultrasonic blade drops when it is immersed in a surgical field filled with fluid (e.g. blood, saline, water, etc.). At time t0, the temperature of the ultrasonic blade drops below the desired minimum temperature 133082 and the temperature feedback control algorithm frequency-temperature feedback control algorithm detects the drop in temperature and begins to increase or "raise" the power accordingly. shown by the increase in power 133074 supplied to the ultrasonic blade to initiate the elevation of the temperature of the ultrasonic blade above the minimum desired temperature 133082.

[0616] Referring to Figures 70A and 70B, the ultrasonic generator consists of substantially constant power outputs 133072 while the temperature of the ultrasonic blade remains above the desired minimum temperature 133082. At t0, the processor or control circuit in the generator or in the instrument, or both, detects the drop in temperature of the ultrasonic blade below the minimum desired temperature 133072 and initiates a frequency-temperature feedback control algorithm to raise the temperature of the ultrasonic blade above the minimum desired temperature 133082. Consequently, the energy of the generator begins to rise 133074 at t1 corresponding to the detection of a sudden drop in the temperature of the ultrasonic blade at t0. Under the frequency-temperature feedback control algorithm, the power continues to rise 133074 until the temperature of the ultrasonic blade is above the minimum desired temperature 133082.

[0617] Figure 71 is a logic flow diagram 133090 of a process representing a control program or a logic configuration for controlling the temperature of an ultrasonic blade, in accordance with at least one aspect of the present description. According to the process, the processor or control circuit of the generator or instrument, or both, performs an aspect of a frequency-temperature feedback control algorithm discussed in connection with Figures 70A and 70B to apply 133092 a power level to the ultrasonic transducer to achieve a desired temperature on the ultrasonic blade. The 133094 generator monitors the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to drive the ultrasonic transducer. Based on the phase angle Φ, the generator infers 133096 the temperature of the ultrasonic blade using the techniques described herein in relation to Figures 66A through 68. The generator determines 133098 whether the temperature of the ultrasonic blade is below a desired minimum temperature by comparing the inferred temperature of the ultrasonic blade with a predetermined desired temperature. The generator then adjusts the level of power applied to the ultrasonic transducer based on the comparison. For example, the process continues along the "NO" branch when the temperature of the ultrasonic blade is at or above the minimum desired temperature and continues along the "YES" branch when the temperature of the ultrasonic blade is below the minimum desired temperature. When the temperature of the ultrasonic blade is below the minimum desired temperature, the generator increases the power level for the ultrasonic transducer, for example, by increasing the voltage signals Vg(t) and/or current Ig(t), to raise the temperature of the ultrasonic blade and continues to increase the level of power applied to the ultrasonic transducer until the temperature of the ultrasonic blade increases above the minimum desired temperature.

Situational awareness

[0618] Referring to Figure 72, a timeline 5200 is illustrated representing situational awareness of a central controller, such as the central surgical controller 106 or 206, for example. The timeline 5200 is an illustrative surgical procedure and the contextual information that the surgical hub 106, 206 can derive from the data received from the data sources at each step in the surgical procedure. Timeline 5200 represents the typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a lung segmentectomy procedure, beginning with setting up the operating room and ending with transferring the patient to an operating room. post-operative recovery.

[0619] The situationally aware surgical core controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the core surgical controller 106 , 206. The central surgical controller 106, 206 may receive this data from the paired modular devices and other data sources and continually derive inferences (i.e., contextual information) about the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situational awareness system of the surgical hub 106, 206 is capable of, for example, recording data regarding the procedure to generate reports, verifying steps being taken by medical personnel, providing data or warnings (e.g., via a display screen ) that may be pertinent to the specific step of the procedure, adjust modular devices based on context (e.g., activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the power level of an instrument ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.

[0620] In the first step 5202, in this illustrative procedure, hospital staff members retrieve the patient's electronic medical record (EPR) from the hospital's EMR database. Based on the patient selection data in the PEP, the surgical hub 106, 206 determines that the procedure to be performed is a thoracic procedure.

[0621] In the second step 5204, team members scan the incoming medical supplies for the procedure. The surgical hub 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the mix of supplies corresponds to a thoracic procedure. Furthermore, the surgical hub 106, 206 is also capable of determining that the procedure is not a wedge procedure (because the input supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or otherwise that input supplies do not correspond to a thoracic wedge procedure).

[0622] In the third step 5206, medical personnel scan the patient's band with a scanner that is communicably connected to the surgical hub 106, 206. The surgical hub 106, 206 can then confirm the patient's identity based on the scanned data .

[0623] In the fourth step 5208, medical personnel turn on auxiliary equipment. The auxiliary equipment being used may vary depending on the type of surgical procedure and the techniques being used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices may automatically pair with the surgical hub 106, 206 that is situated within a specific vicinity of the modular devices as part of its initialization process. The surgical hub 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond to it during this pre-operative or initialization phase. In this particular example, the surgical hub 106, 206 determines that the surgical procedure is a VATS (video-assisted thoracic surgery) procedure based on this specific combination of paired modular devices. Based on the combination of electronic patient record (EPR) data, the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the hub, the surgical hub 106, 206 can generally infer the specific procedure that the surgical team will perform. Once the surgical hub 106, 206 recognizes which specific procedure is being performed, the surgical hub 106, 206 can then retrieve the steps of that process from a memory or from the cloud and then cross-reference the data it subsequently receives from the data sources. connected data (e.g., modular devices and patient monitoring devices) to infer which step of the surgical procedure the surgical team is performing.

[0624] In the fifth step 5210, team members attach electrocardiogram (ECG) electrodes and other patient monitoring devices to the patient. The ECG electrodes and other patient monitoring devices are capable of pairing with the surgical hub 106, 206. As the surgical hub 106, 206 begins to receive data from the patient monitoring devices, the surgical hub 106, 206 thereby confirms that the patient is in the operating room.

[0625] In the sixth step 5212, medical personnel induced anesthesia in the patient. The surgical hub 106, 206 may infer that the patient is under anesthesia based on data from the modular devices and/or patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations thereof. , for example. After completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.

[0626] In the seventh step 5214, the lung of the patient being operated on is retracted (while ventilation is switched to the contralateral lung). The surgical hub 106, 206 may infer from the ventilator data that the patient's lung has been retracted, for example. The surgical hub 106, 206 can infer that the operative portion of the procedure has begun when it can compare the detection of the patient's lung collapse to the expected steps of the procedure (which can be accessed or retrieved earlier) and thus determine that the lung collapse is the first operative step in this specific procedure.

[0627] In the eighth step 5216, the medical imaging device (e.g., a display device) is inserted and video from the medical imaging device is started. The surgical hub 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device. Upon receipt of data from the medical imaging device, the surgical hub 106, 206 may determine that the laparoscopic portion of the surgical procedure has begun. Additionally, the surgical hub 106, 206 may determine that the specific procedure being performed is a segmentectomy rather than a lobectomy (note that a wedge procedure has already been ruled out by the surgical hub 106, 206 based on data received in the second step 5204 of the procedure). Data from the medical imaging device 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in a number of different ways, including by determining the angle at which the medical imaging device is oriented in In relation to viewing the patient's anatomy, monitor the number of medical imaging devices being used (i.e., that are activated and paired with the operating room 106, 206), and monitor the types of visualization devices used. For example, a technique for performing a VATS lobectomy places the camera in the lower anterior corner of the patient's thoracic cavity above the diaphragm, while a technique for performing a VATS segmentectomy places the camera in an anterior intercostal position relative to the fissure of the segment. Using standard recognition or machine learning techniques, for example, the situational recognition system can be trained to recognize the positioning of the medical imaging device according to the visualization of the patient's anatomy. As another example, one technique for performing a VATS lobectomy uses a single medical imaging device, while another technique for performing a VATS segmentectomy uses multiple cameras. As yet another example, a technique for performing a VATS segmentectomy uses an infrared light source (which may be communicably coupled to the surgical hub as part of the visualization system) to visualize the cleft segment, which is not used in a VATS lobectomy. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 can thus determine the specific type of surgical procedure being performed and/or the technique being used for a specific type of surgical procedure. .

[0628] In the ninth step 5218 of the procedure, the surgical team begins the dissection stage. The surgical hub 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because it receives data from the RF or ultrasonic generator that indicates that an energy instrument is being fired. The surgical hub 106, 206 may cross-reference the received data with the retrieved steps of the surgical procedure to determine that an energy instrument being fired at that point in the process (i.e., upon completion of the previously discussed steps of the procedure) corresponds to the dissection step. . In certain cases, the power instrument may be a power tool mounted on a robotic arm of a robotic surgical system.

[0629] In the tenth step 5220 of the procedure, the surgical team proceeds to the bonding step. The surgical hub 106, 206 can infer that the surgeon is ligating the arteries and veins because it receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the surgical hub 106, 206 can derive this inference by crossing the reception data from the surgical stapling and cutting instrument with the steps retrieved in the process. In certain cases, the surgical instrument may be a surgical tool mounted on a robotic arm of a robotic surgical system.

[0630] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. The surgical hub 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical cutting and stapling instrument, including data from its cartridge. Cartridge data may correspond to the size or type of staple being fired by the instrument, for example. As different types of staples are used for different types of tissue, the cartridge data can thus indicate the type of tissue being stapled and/or transected. In this case, the type of staple that is fired is used for parenchyma (or other similar types of tissue), which allows the surgical hub 106, 206 to infer which segmentectomy portion of the procedure is being performed.

[0631] In the twelfth step 5224, the node dissection step is then performed. The surgical hub 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on data received from the generator that indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the surgical hub 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling/cutting instruments and surgical energy instruments (i.e., RF or ultrasonic) depending on the specific step in the procedure because different instruments are better adapted for specific tasks. Therefore, the specific sequence in which the cutting/stapling instruments and surgical power instruments are used can indicate which step of the procedure the surgeon is performing. Additionally, in certain cases, robotic tools may be used for one or more steps in a surgical procedure and/or handheld surgical instruments may be used for one or more steps in the surgical procedure. The surgeon can switch between robotic tools and handheld surgical instruments and/or can use the devices simultaneously, for example. After completion of the twelfth step 5224, the incisions are closed and the post-operative portion of the process begins.

[0632] In the thirteenth step 5226, the patient's anesthesia is reversed. The surgical hub 106, 206 may infer that the patient is emerging from anesthesia based on ventilator data (i.e., the patient's respiratory rate begins to increase), for example.

[0633] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. The surgical hub 106, 206 can thus infer that the patient is being transferred to a recovery room when the hub loses ECG, blood pressure, and other data from the patient monitoring devices. As can be seen from the description of this illustrative procedure, the surgical hub 106, 206 can determine or infer when each step of a given surgical procedure is occurring in accordance with data received from various data sources that are communicably coupled to the surgical hub. 106, 206.

[0634] Situational awareness is further described in US provisional patent application serial no. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is incorporated herein by reference in its entirety. In certain instances, the operation of a robotic surgical system, including the various robotic surgical systems described herein, for example, may be controlled by the central controller 106, 206 based on its situational awareness and/or feedback from components thereof and/or based on information from cloud 102.

Situational recognition of electrosurgical systems

[0635] Electrosurgical instruments are used to treat different types of tissue by applying energy to the tissue. As described with respect to Figures 22 to 24, an electrosurgical instrument (e.g., surgical instruments 1104, 1106, 1108) may be connected to a generator 1100, and includes an end actuator (e.g., end actuators 1122, 1124, 1125) configured to retain and transmit therapeutic energy to tissue.

[0636] In various aspects, the end actuator can be used to seal, weld, or coagulate tissue, such as a blood vessel, by applying energy to the blood vessel while it is held by the end actuator. Since blood vessels are generally surrounded by protective tissue, the tissue needs to be separated to expose the blood vessels for an effective seal to be achieved. However, tissue separation requires less energy than tissue sealing or coagulation. Furthermore, the amount of tissue to be separated varies depending, for example, on the anatomical location of the blood vessel, the state of the tissue and the type of surgery being performed.

[0637] A technique for treating a tissue including a blood vessel involves separating and moving the inner muscular layer of the blood vessel away from the adventitial layer before sealing and/or transection of the blood vessel. To more effectively separate tissue layers from the blood vessel, low-level energy sufficient to separate but not coagulate or seal the tissue can be generated and transmitted to the tissue. Subsequently, high-level energy is used to seal or coagulate the tissue.

[0638] Successful energy treatment of tissue secured by an end actuator depends on choosing a suitable energy mode of operation for each stage of closure of the end actuator. Furthermore, the closure stages of an extremity actuator can be determined by various situational parameters such as, for example, the type, anatomical location and/or tissue composition. Several suitable situational parameters are described in the item "SITUATIONAL RECOGNITION" in relation to Figure 72.

[0639] Aspects of the present description present various processes for selecting different energy modes for different stages of closing an end actuator of an electrosurgical instrument. The selection may be based, at least in part, on one or more situational parameters.

[0640] In various aspects, the interaction of the tissue with the end actuator during closure provides one or more situational parameters that may be useful in selecting or adjusting an energy mode for treating the tissue. Figure 73 illustrates an end actuator 131000 extending from a drive shaft 131001 and subjected to closing movements to clamp the "T" fabric. The end actuator 131000 includes a first claw 131002 and a second claw 131004. At least one of the first claw 131002 and the second claw 131004 is movable relative to the other to grip the fabric between them. In various aspects, a closing stage may be defined by one or more angular positions of the first claw 131002 relative to the second claw 131004, or one or more angular distances between the first claw 131002 and the second claw 131004.

[0641] In the example of Figure 73, the first gripper 131002 is movable relative to the second gripper 131004 to transition the end actuator through different stages of closure between an open configuration and a closed configuration to clamp tissue between the grippers. 131002, 131004. Figure 73 represents two stages of closure. In a first closing stage, the first gripper 131002 is moved an angular distance θ1 from the open configuration.

[0642] The first closing stage is directly followed by a second closing stage extending an angular distance θ2 from the open configuration of end actuator 131000. Although only two closing stages are depicted in the example of Figure 73, An end actuator in accordance with the present description may be transitioned through more or less than two closing stages.

[0643] Figures 75A and 75B are schematic diagrams of end actuator 131000 subjected to closing movements to separate, seal and transect the "T" fabric. In Figure 75A, the end actuator 131000 is in a first stage of closure and an initial contact with the "T" fabric has been established. In Figure 75B, the first gripper 131002 has completed the first closing stage and is about to begin a second closing stage.

[0644] Referring to Figure 74, a graph 131010 represents a first therapeutic cycle 131012 applied to the "T" tissue of Figures 75A and 75B. Time is represented on the x axis, while amplitude is represented on the y axis. The first therapeutic cycle 131012 comprises an initial tissue separation energy mode that performs tissue separation in the first closure stage by applying a first energy to the "T" tissue. The first therapeutic cycle 131012 further comprises a tissue sealing energy mode that performs tissue sealing by applying a second energy, higher than the first energy, to the "T" tissue in the second stage of closure.

[0645] A second therapeutic cycle 131014 is also represented in graph 131010 of Figure 74. The second therapeutic cycle 131014 comprises only a tissue sealing energy mode. In other words, in the second therapeutic cycle 131014, the tissue sealing energy mode does not follow an initial tissue separation energy mode. Second therapeutic cycle 131014 is suitable for use in certain situations where tissue separation is not necessary.

[0646] Figure 76 is a logic flow diagram of a process 131020 depicting a control program or logic configuration for selecting a power operating mode of an electrosurgical instrument. The process 131020 detects 131022 closing stages of the end actuator 131000. The process 131020 further selects 131024, among the power modes, the application of different power outputs based on the detected closing stages of the end actuator 131000. In an example , a first power mode that applies a first power output is selected in a first closing stage, while a second power mode that applies a second power output, higher than the first power output, is selected in a second closing stage. The first energy output is sufficient to separate, but not seal, the "T" fabric, while the second energy output is sufficient to seal the "T" fabric.

[0647] In certain aspects, one or more of the processes of the present description may be performed by a control circuit of the electrosurgical instrument such as, for example, the control circuit 710 of the surgical instrument 700, the control circuit 760 of the surgical instrument 750 and/or the control circuit 760 of the surgical instrument 790. In certain aspects, as illustrated in Figure 13, a control circuit 500 for performing one or more of the processes of the present disclosure may comprise one or more processors 502 (e.g., microprocessor , microcontroller) coupled to at least one memory circuit 504 that stores program instructions, which, when executed by processor 502, cause processor 502 to execute the one or more processes. Alternatively, one or more of the processes of the present disclosure may be performed by one or more of the control circuits depicted in Figures 14 and 15. In certain aspects, an electrosurgical instrument may include a non-transient storage medium that stores one or more algorithms. to perform one or more of the processes of the present description.

[0648] Figure 77 is another logic flow diagram of a process 131030 representing a control program or a logic configuration for selecting a power operating mode of an electrosurgical instrument. Process 131030 selects an operating mode from operating modes that apply different power outputs based on sensor signals indicative of closing stages of end actuator 131000. In one example, the process of Figure 77 is performed by a control circuit. control connected to one or more sensors configured to generate sensor signals indicative of the closing stages of the end actuator 131000. The sensor signals are received 131032 by the control circuit that selects a power operating mode from operating modes that apply different power outputs based on received sensor signals. The control circuit, for example, determines 131034 whether received sensor signals indicate that the end actuator 131000 is in the first stage of closing. If this is the case, the control circuit selects a first operating mode that causes a first energy output to be applied 131036 to the "T" fabric. If the received sensor signal does not indicate that the end actuator is in the first stage of closing, the control circuit further determines 131038 whether the received sensor signal indicates that the end actuator 131000 is in the second stage of closing. If this is the case, the control circuit selects a second operating mode that causes a second energy output, higher than the first energy output, to be applied 131039 to the "T" fabric.

[0649] In various exemplifications, the control circuit of the ultrasonic surgical instrument is configured to cause the transducer to change the magnitude of the ultrasonic energy output in response to the transition of the clamping member from the first closing stage to the second closing stage .

[0650] In various exemplifications, the control circuit is configured to correlate a change in the magnitude of the power output to a transition from the first closing stage to the second closing stage. In several examples, the second energy output is sufficient to seal and coagulate the tissue, whereas the first energy output is sufficient to separate the tissue but not to seal or coagulate the tissue. Although only two power operating modes are depicted in the example of Figure 77, an electrosurgical instrument in accordance with the present disclosure may include more or less than two power operating modes, each corresponding to a predetermined closure stage of the end actuator 131000 In several examples, the tissue separation mode is defined by a lower amplitude and/or frequency than those of the tissue coagulation and sealing mode.

[0651] Figure 78 is another logic flow diagram of a process 131040 representing a control program or a logic configuration for selecting a power operating mode of the electrosurgical instrument. Process 131040 is similar in many respects to the process of Figure 76. Additionally, process 131040 determines 131042 when an initial contact with the "T" fabric is made (see Figure 75A) as the first claw 131002 is moved through the stages of closure between the open configuration and the closed configuration. More specifically, the selection between electrosurgical instrument power operating modes is based on the closure stage at which initial contact with the "T" tissue is detected.

[0652] In various aspects, initial tissue contact may be detected by a tissue contact circuit comprising first claw electrodes and second claw electrodes. The first claw electrodes are coupled to one pole of an electrosurgical power source and the second claw electrodes are coupled to an opposite pole of the electrosurgical power source. When the tissue is simultaneously in contact with the first claw electrodes and the second claw electrodes, the tissue contact circuit is in a closed configuration, allowing a non-therapeutic signal to pass between the claws 131002, 131004. Consequently, an electrical continuity is established between the claws 131002, 131004, between which the fabric is situated, and no electrical continuity is established between the claws 131002, 131004 between which no fabric is situated.

[0653] In various aspects, initial contact with the tissue is made when the claws 131002, 131004 exert sufficient compression on the tissue "T" trapped between them to cause a detection circuit "SC" to be closed.

[0654] Figure 78A is a schematic illustration of an example tissue contact circuit showing completion of the circuit after tissue contact with a pair of closely spaced contact plates. The contact of the grippers 131002, 131004 with the fabric "T" closes a detection circuit "SC" which is otherwise open, by establishing contact with a pair of opposing plates "P1, P2" provided on the grippers 131002, 131004. Closing the "SC" detection circuit causes a sensor signal to be transmitted to a control circuit (e.g., Figures 13 through 14, 17 through 19). The sensor signal indicates that initial tissue contact has been established. Figure 78A and additional exemplifications are further described in US Patent No. 8,181,839, filed on June 27, 2011, entitled SURGICAL INSTRUMENT EMPLOYING SENSORS, granted on May 5, 2012, the description of which is incorporated herein by reference. in its entirety.

[0655] Figure 79 is another logic flow diagram of a process 131050 depicting a control program or logic configuration for selecting a power operating mode of an electrosurgical instrument based on the closure stage at which initial contact with the "T" tissue is detected. Process 131050 includes receiving 131052 the first and second sensor signals. In one example, process 131050 is performed by a control circuit (e.g., Figures 13-14, 17-19) connected to at least one first sensor configured to generate sensor signals indicative of closing stages of end actuator 131000 The control circuit is also connected to at least one second sensor configured to generate sensor signals indicative of detection of an initial contact with the "T" fabric. The sensor signals coming from the first and second sensors are transmitted to the control circuit.

[0656] Process 131050 further determines 131054 whether the first sensor signals indicate that the end actuator 131000 is in a first stage of closing. If this is the case, process 131050 further determines 131056 whether the second sensor signals indicate that an initial contact with the tissue has been established.

[0657] If the first sensor signals indicate that the end actuator 131000 is in a first stage of closure, and if the second sensor signals indicate that an initial contact with the tissue has been established, a first power output is applied 131058 to the "T" fabric. In one example, the control circuit selects a first operating mode that causes the first power output to be applied 131058 to the "T" fabric.

[0658] Conversely, if the end actuator 131000 is not in the first closing stage, the process 131050 further determines 131060 whether the end actuator 131000 is in the second closing stage. If this is the case, process 131050 further determines 131062 whether the second sensor signals indicate that an initial contact with the tissue was established in the second stage of closure.

[0659] If the first sensor signals indicate that the end actuator 131000 is in a second stage of closure, and if the second sensor signals indicate that an initial contact with the tissue has been established in the second stage of closure, a second output of energy, higher than the first energy output, is applied 131064 to the "T" fabric. In one example, the control circuit selects a second operating mode that causes the second power output to be applied 131064 to the "T" fabric.

[0660] In other words, a detection of an initial tissue contact in the first closing stage causes the control circuit to provide a first energy output to the tissue "T", while a detection of the initial tissue contact in the second stage of closure causes the control circuit to provide a second power output to the "T" fabric. As described above, in many aspects, the second energy output is sufficient to seal and coagulate the tissue, whereas the first energy output is sufficient to separate the tissue, but not to seal or coagulate the tissue.

[0661] In various aspects, as described in more detail above, a closing stage may be defined by an angular position, or a range of angular positions, of the first claw 131002 relative to the second claw 131004. In certain cases, the first and the second closing stage may span predetermined portions of the maximum angular distance between the jaws 131002, 131004 in the open configuration. An end actuator 131000 completes a full closing cycle by moving the first claw 131002 relative to the second claw 131004 by the maximum angular distance.

[0662] In one example, the first closing stage spans a first angular distance and the second closing stage spans a second angular distance. In one example, the first and second angular distances are equal or at least substantially equal. In one example, the second angular distance directly follows the first angular distance. Alternatively, in another example, the first angular distance is spaced from the second angular distance. In an example, the ratio of the first angular distance to the second angular distance is selected from a range of about 0.5 to about 2, for example.

[0663] In one example, the first closing stage covers the first half of the maximum angular distance and the second closing stage covers the second half of the maximum angular distance. Accordingly, a detection of an initial tissue contact at any point up to 50% of the full closing cycle of the end actuator 131000 results in the first energy output, in accordance with process 131050, while a detection of the initial tissue contact at a point beyond the 50% mark results in the second energy output.

[0664] Angular position is not the only identifying characteristic of a closing stage of end actuator 131000. As described below in relation to Figure 80, closing movements of an end actuator 131000 are driven by a drive member longitudinally movable 131110. The longitudinal position of the longitudinally movable drive member 131110 is another identifying feature of a closing stage. The longitudinal movement of the longitudinally movable drive member 131110 corresponds to the angular movement of the first claw 131002 relative to the second claw 131004, and is monitored by an absolute positioning system 7000.

[0665] In various examples, a control circuit (e.g., Figures 13 to 14, 17 to 19) of an electrosurgical instrument includes a storage medium that stores, among other things, information characteristic of the closing stages of the end actuator 131000 such as, for example, the starting point of a closing stage, the ending point of a closing stage, the angular position(s) of the first gripper 131002 that is (are) associated ) to a closing stage and/or the longitudinal position(s) of the longitudinally movable drive member 131110 that is (are) associated with a closing stage.

[0666] As illustrated in Figure 80, the absolute positioning system 7000 is configured to track the closure of the end actuator 131000. Based on the stored information and the output of the absolute positioning system 7000, a control circuit (e.g., Figures 13-14, 17-19) of the electrosurgical instrument can determine the closing stages of the end actuator 131000 as it transitions between the open configuration and the closed configuration.

[0667] In certain aspects, a drive system is configured to apply drive movements to stimulate the end actuator 131000 through the closing stages. The drive system may employ an electric motor 131102. In various forms, the motor 131102 may be a brushed direct current drive motor, with a maximum rotational speed of approximately 25,000 RPM, for example. In other arrangements, the motor 131102 may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor, or any other suitable type of electric motor. A battery 1104 (or "power supply" or "battery pack"), such as a Li-ion battery, for example, can provide power to the control circuit and ultimately the motor 131102.

[0668] The electric motor 131102 may include a rotary drive shaft 7016, which is operationally interfaced with a gear reducer assembly 7014, which is mounted in coupling engagement with a set, or rack, of drive teeth on a drive member. longitudinally movable 131110. In use, a voltage polarity supplied by the battery 1104 can operate the electric motor 131102 in a clockwise direction, wherein the voltage polarity applied to the electric motor 131102 by the battery 1104 can be reversed so as to operate the electric motor 131102 in a counterclockwise direction. When the electric motor 131102 is rotated in one direction, the longitudinally movable drive member 131110 will be driven axially in the distal "D" direction, causing the first claw 131002 to move through the closing stages from the open configuration to the closed configuration. When the motor 131102 is driven in an opposite rotary direction, the drive member 131110 will be axially activated in the proximal "P" direction, transitioning the first claw 131002 back to the open configuration.

[0669] Figure 80 is a schematic diagram of an absolute positioning system 7000 comprising a motor drive circuit arrangement controlled by microcontroller 7004 comprising a sensor arrangement 7002, in accordance with one embodiment. The electrical and electronic circuit elements associated with the absolute positioning system 7000 and/or the sensor array 7002 are supported by the control circuit board assembly. The microcontroller 7004 generally comprises a memory 7006 and a microprocessor 7008 ("processor") operatively coupled thereto. The processor 7008 controls a motor driver circuit 7010 to control the position and speed of the motor 131102. The motor 131102 is operatively coupled to the sensor arrangement 7002 and an absolute position sensor arrangement 7012 to provide a unique position signal to the microcontroller 7004 for each possible location of the longitudinally movable drive member 131110 and, consequently, each possible location of the first gripper 131002.

[0670] The unique position signal is provided to the microcontroller 7004 through the feedback element 7024. It will be recognized that the unique position signal may be an analog signal or digital value based on the interface between the position sensor 7012 and the microcontroller 7004. In one aspect, the interface between the position sensor 7012 and the microcontroller 7004 is a standard serial peripheral interface (SPI) and the unique position signal is a digital value representing the position of a sensing element 7026 during one revolution. The value representing the absolute position of the sensing element 7026 during one revolution may be stored in memory 7006. The feedback value of the absolute position of the sensing element 7026 corresponds to the position of the first claw 131002.

[0671] Additionally, other sensor(s) 7018 may be provided to measure other parameters associated with the absolute positioning system 7000. One or more screen indicators 7020 may also be provided which may include an audible component.

[0672] A sensor arrangement 7002 provides a unique position signal corresponding to the location of the longitudinally movable drive member 131110. The electric motor 131102 may include a rotary drive shaft 7016, which operationally interfaces with a gear assembly 7014, which is mounted in coupling engagement with a set, or rack, of drive teeth on the longitudinally movable drive member 131110. Sensing element 7026 may be operatively coupled to gear assembly 7014 such that a single revolution of sensing element 7026 corresponds to some linear longitudinal translation of the longitudinally movable drive member 131110.

[0673] The sensor arrangement 7002 for the absolute positioning system 7000 uses a position sensor 7012 that generates a unique position signal for each rotational position in the same revolution of a sensing element associated with the position sensor 7012. Thus, each revolution of the sensing element associated with the position sensor 7012 is equivalent to a longitudinal linear displacement d1 of the longitudinally movable drive member 131110. In other words, d1 is the longitudinal linear distance by which the longitudinally movable drive member 131110 moves from the point "a" to point "b" after a single revolution of a sensing element coupled to the longitudinally movable drive member 131110. A series of switches 7022a to 7022n, where n is an integer greater than one, may be used alone or in combination with gear reduction to provide a unique position signal for more than one revolution of the position sensor 7012. The state of switches 7022a through 7022n is fed back to the 7004 microcontroller, which applies logic to determine a unique position signal corresponding to the displacement longitudinal linear dl + d2 + ... dn of the longitudinally movable drive member 131110, which corresponds to a unique position of the first claw 131002 between the open configuration and the closed configuration.

[0674] In various embodiments, the position sensor 7012 of the sensor arrangement 7002 may comprise one or more magnetic sensors, an analog rotary sensor such as a potentiometer, an array of analog Hall effect elements that output a unique combination of signals, or values, among others, for example.

[0675] In various aspects, the motor 131102 is replaced by a manual trigger that manually actuates the longitudinally movable drive member 131110. The manual trigger may form part of a handle of the ultrasonic surgical instrument. In these aspects, the absolute positioning system 7000 is configured to track the manual advancement and retraction of the longitudinally movable drive member 131110.

[0676] In various aspects, the microcontroller 7004 can be programmed to perform various functions, such as precisely controlling the speed and position of the first gripper 131002. Using known physical properties, the microcontroller 7004 can be designed to determine the position of the first gripper 131002 and/or the rate of movement of the first gripper 131002 throughout its entire range of motion, which can further be used to determine a current closing stage of the first gripper 131002. Additional details regarding the absolute positioning system are disclosed in US Patent Application Serial No. 13/803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, and filed on March 14, 2013, which is incorporated herein by reference in its entirety.

[0677] In certain aspects, the closure stages are defined or characterized by predetermined positions that can be stored in a storage medium of a control circuit (e.g., Figures 13 to 15, 17 to 19). The position sensor 7012 transmits to the control circuit sensor signals indicative of the position of the longitudinally movable drive member 131110 throughout its range of motion. Since the position of the longitudinally movable drive member 131110 corresponds to the position of the first claw 131002, the control circuit can evaluate a closing stage of the end actuator 131000 based on the received sensor signals and the predetermined position data stored in the storage medium.

[0678] For example, a first closing stage may encompass a first range of positions, whereas a second closing stage may encompass a second range of positions in addition to the first range of positions. Accordingly, sensor signals from the position sensor 7012 which indicate that the position of the longitudinally movable drive member 131110 is in the first range of positions, cause the processor 7008 to determine that the end actuator 131000 is in the first closing stage and , consequently, select a first power operating mode. On the other hand, sensor signals from position sensor 7012 which indicate that the position of the longitudinally movable actuating member 131110 is in the second range of positions, cause the processor 7008 to determine that the end actuator 131000 is in the second stage of closure and consequently select a second power operating mode different from the first power operating mode. As discussed above, the second energy operating mode may result in a second energy output that is sufficient to seal and coagulate the tissue, whereas the first energy operating mode may result in a first energy output that is sufficient to separate the tissue, but not to seal or coagulate the tissue.

[0679] Another closing stage identification characteristic of the end actuator 131000 includes the closing speed. The motor 131102 (Figure 80) may be configured to stimulate the longitudinally movable drive member 131110, which drives the first gripper 131002 at a constant speed. However, as the first gripper 131002 interacts with the "T" fabric, the closing speed may vary depending on the characteristics of portions of the "T" fabric that interact with the first gripper 131002. Consequently, a change in the closing speed may be a closing stage identification feature of the end actuator 131000. The closing speed may change as the end actuator 131000 transitions from one tissue portion to another, such as a transition from a suitable tissue portion to separating the fabric to a portion of fabric suitable for sealing the fabric. The change in the rate of movement of the first claw 131002 may indicate completion of tissue separation, which precedes tissue sealing and coagulation.

[0680] In certain aspects, the closure stages are defined or characterized by predetermined rates of movement that can be stored in a storage medium of a control circuit (e.g., Figures 13 to 15, 17 to 19). The rate of movement of the longitudinally movable drive member 131110, which corresponds to the rate of movement of the first claw 131002, can be determined based on sensor signals from the position sensor 7012. In certain aspects, a change in the rate of movement of the member longitudinally movable drive circuit 131110 indicates a transition from a first closing stage to a second closing stage, which may cause the control circuit to switch from the first power operating mode to the second power operating mode.

[0681] Another closing stage identification feature of the end actuator 131000 includes the clamping load. As with the closing speed, the load exerted by the end actuator 131000 on the fabric "T" may change depending on the characteristics of portions of the fabric "T" that interact with the first gripper 131002. Consequently, a change in the clamping load may be an identifying characteristic of closing stages of the end actuator 131000. The clamping load may change as the end actuator 131000 transitions from one portion of fabric to another, e.g., a transition from a portion of fabric suitable for separating the fabric into a portion of fabric suitable for sealing the fabric. The change in clamping load may indicate completion of tissue separation, which precedes tissue sealing and coagulation.

[0682] Figure 81 is a logic flow diagram of a process 131070 representing a control program or a logic configuration for switching between power operating modes of an electrosurgical instrument, in accordance with at least one aspect of the present description. The process 131070 comprises detecting 131072 the closing speed and clamping load of an end actuator 131000. The closing speed can be monitored by the absolute positioning system 7000. The clamping load can be determined using sensors 8406, 8408a, 8408b, as described with respect to Figures 51 and 52. Sensors 8406, 8408a, 8408b are electrically connected to a control circuit such as control circuit 7400 (Figure 49) through interface circuits. Process 131070 further includes determining 131074 whether the closing speed has been modified beyond a predetermined limit. A storage means of the control circuit carrying out process 131070 may store a predetermined threshold value. The current closing speed may be compared to the predetermined limit to determine whether the current closing speed reaches or exceeds the predetermined limit. Process 131070 also determines 131076 whether the clamping load has been modified beyond a predetermined limit. A storage medium of the control circuit executing process 131070 may store a predetermined threshold value. The current clamping load can be compared to the predetermined limit to determine whether the current clamping load reaches or exceeds the predetermined limit. An occurrence of either of the two events causes the process 131070 to switch 131078 from a tissue separation energy mode to a tissue sealing energy mode.

[0683] In various cases, the end actuator 131000 may be in the form of an ultrasonic end actuator adapted for use with an ultrasonic surgical instrument 1104, an RF end actuator adapted for use with an RF electrosurgical instrument 1106, or a combined end actuator adapted for use with a multifunctional surgical instrument 1108, as described with respect to Figures 17 to 19, 22 to 24. Any of the instruments 1104, 1106, 1108 can be configured to perform one or more of the processes 131020, 131030, 131040, 131050,131070, as described above.

[0684] In examples where the end actuator 131000 is in the form of an ultrasonic end actuator, the grippers 131002, 131004 may be in the form of a gripping member and an ultrasonic blade. The gripping member can be moved relative to the ultrasonic blade to clamp the tissue between them. As described above in more detail, the ultrasonic generator can be activated to apply power to an ultrasonic transducer that is acoustically coupled to the ultrasonic blade via an ultrasonic waveguide.

[0685] In various aspects, a first ultrasonic frequency may be set initially, during a first stage of closure, to mechanically separate the muscle tissue layer of a vessel before applying a second ultrasonic frequency, during a second stage of closure, to cut and seal the vessel.

[0686] An ultrasonic generator module is programmed to provide a first drive frequency f1 during a first closing stage, wherein the first frequency f1 is significantly out of resonance, e.g., fo/2, 2fo or other structural resonant frequencies, where fo is the resonant frequency (e.g. 55.5 kHz). The first frequency f1 provides a low level of mechanical vibration action for the ultrasonic blade which, associated with the clamping force, mechanically separates the muscular tissue layer (subtherapeutic) from the vessel without generating significant heating that, in general, occurs in resonance . During a second closing stage, the ultrasonic generator module is programmed to automatically switch the drive frequency to the fo resonance frequency to transect and seal the vessel.

[0687] In various aspects, the ultrasonic surgical instrument is connected to a central surgical controller that interacts with a cloud-based system as described with respect to Figures 1 through 11. In such cases, the electrosurgical instrument control circuit may receive inputs referring to various situational parameters collected by the central surgical controller and/or the cloud-based system. These inputs can be helpful in selecting a suitable operating power mode. Additionally, the energy levels generated by the transducer can be specifically tailored to the type of tissue being treated. Situational parameters include, but are not limited to, tissue type, tissue anatomical location, and/or tissue composition. For example, the energy required for tissue separation in the liver or other solid organs may be different from that for other organs. Additionally, energy levels for tissue separation may be higher to accommodate tissue adhesions or other unfixed connective tissue, as reported by the central surgical controller. Additional details about the situational awareness of the central surgical controller, the cloud-based system and various surgical instruments are described in the item "SITUATIONAL RECOGNITION".

Control of different electromechanical systems of an electrosurgical instrument

[0688] Various surgical instruments include end actuators that clamp tissue and apply RF energy, ultrasonic energy, or the combination of RF energy and ultrasonic energy to the trapped tissue, as described in relation to Figures 22 to 24. Optimal treatment of tissue is accomplished by carefully modulating the application of energy to the tissue and the compression of the tissue, actions performed by separate systems that nevertheless influence each other's effect on tissue. For example, the application of energy to the tissue can be influenced by the water content of the tissue which is influenced by the compression applied to the tissue. Increasing the compression applied to the fabric increases the speed at which the water content of the fabric leaves the fabric held by the end actuator which, in turn, influences the conductivity of the fabric.

[0689] Aspects of the present description provide various processes for modulating systems of an electrosurgical instrument that act separately on tissue, but nevertheless have interrelated impacts on tissue. Using the same parameter to modulate separate systems of an electrosurgical instrument that have interrelated impacts on tissue ensures consistency of the systems' effect on tissue. In other words, relying on the same parameter to coordinate the functioning of these systems allows for a better correlated effect on the tissue.

[0690] In certain aspects, one or more of the processes of the present description may be performed by a control circuit of an electrosurgical instrument, such as, for example, the control circuit 710 of the surgical instrument 700 and/or the control circuit 760 of surgical instruments 750, 790. In certain aspects, as illustrated in Figure 13, a control circuit for executing the one or more processes may comprise one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one control circuit. memory 504 that stores program instructions, which, when executed by processor 502, cause processor 502 to execute the one or more processes. Alternatively, the one or more processes may be performed by one or more of the control circuits depicted in Figures 14 and 15. In certain aspects, an electrosurgical instrument may include a non-transitory storage medium that stores one or more algorithms for executing the one or more processes.

[0691] Figure 82 is a logic flow diagram of a process 131100 depicting a control program or logic configuration for modulating the systems of a surgical instrument (e.g., the surgical instruments 700, 750, 790, 1104, 1106, 1108) in accordance with at least one aspect of the present description. Process 131100 monitors 131101 a parameter of the surgical instrument. In several examples, the electrosurgical instrument includes an end actuator 131000. In certain examples, the parameter is an impedance of the tissue clamped by the end actuator 131000. In another example, the parameter is a temperature of the tissue clamped.

[0692] Process 131100 further makes a change 131104 in the energy applied to the tissue in response to reaching or exceeding 131106 a predetermined upper limit of the parameter. Process 131100 further makes a change 131108 in the energy applied to a motor (e.g., motors 603, 704a, 754) of the surgical instrument in response to reaching or exceeding 131109 a predetermined lower limit of the parameter. The motor is operatively coupled to the end actuator 131000, such that power applied to the motor causes the motor to transition the end actuator 131000 toward the closed configuration. Accordingly, process 131100 makes a change in closure of the end actuator in response to reaching or exceeding 131109 a predetermined lower limit of the parameter.

[0693] In the example of Figure 82, the modification in closing the end actuator is carried out by modifying the energy applied to the motor. In other instances, the modification to the end actuator closure may be accomplished differently via a gearbox assembly, for example. A clutch mechanism may be configured to engage or disengage the gearbox assembly to increase or reduce the speed of coupling a drive shaft to the engine and, in turn, perform the desired modification in closing the end actuator.

[0694] In situations where tissue impedance (Z) is the monitored parameter, tissue impedance (Z) may be monitored by one or more sensors, as described in relation to Figures 18, 19, 21, 78A. For example, end actuator 131000 may be equipped with the fabric contact circuit of Figure 78A, wherein the fabric "T" is clamped between plates P1, P2. The tissue impedance (Ztissue) can be calculated based on the formula: where V is the voltage, I is the current, and Zdetection circuit is a predetermined impedance of the "SC" detection circuit, as illustrated in Figure 78A. In several examples, as illustrated with reference to Figure 21, tissue impedance (Z) can be measured by dividing the output of the second voltage sensing circuit 924 by the current sensing circuit 914.

[0695] In situations where tissue impedance (Z) is the monitored parameter, tissue impedance (Z) may be monitored by one or more temperature sensors. Alternatively, the tissue temperature may be determined, as described above in relation to Figures 51 to 53, wherein a flexible circuit 8412 may comprise temperature sensors embedded in one or more layers of the flexible circuit 8412. The one or more temperature sensors may be arranged symmetrically or asymmetrically, and provide tissue temperature feedback 8410 to control circuits of an ultrasonic drive circuit and/or an RF drive circuit. In other examples, as illustrated in relation to Figures 66A and 66B, a change in phase angle Φ and/or generator drive frequency can be used as an indirect or inferred measurement of the temperature of an ultrasonic blade, which in turn Instead, it can be used to estimate or infer the temperature of tissue trapped between the ultrasonic blade and the clamping member of an ultrasonic end actuator.

[0696] Figure 83 is another logic flow diagram of a process 131120 representing a control program or a logic configuration for modulating systems of an electrosurgical instrument (e.g., surgical instruments 700, 750, 790, 1104, 1108) according to at least one aspect of the present description. Process 131120 monitors 131121 a parameter associated with the electrosurgical instrument. As described above in relation to process 131120, the parameter may be an impedance or a temperature associated with the electrosurgical instrument. Process 131120 further performs a change 131124 to a first electromechanical system of the electrosurgical instrument in response to reaching or exceeding 131126 a predetermined upper limit of the parameter. Process 131120 further performs a change 131128 to a second electromechanical system of the electrosurgical instrument, different from the first electromechanical system, in response to reaching or exceeding 131129 a predetermined lower limit of the parameter.

[0697] Figure 84 is a graph 131130 illustrating the implementation of process 131120 in relation to an ultrasonic surgical instrument including the ultrasonic end actuator 1122 of Figure 23, for example. The first electromechanical system is represented by the transducer 1120 and the ultrasonic blade 1128 which is acoustically coupled to the ultrasonic transducer 1120 through a waveguide. The ultrasonic transducer 1120 can be energized with the generator 1100. When driven by the ultrasonic transducer 1120, the ultrasonic blade 1128 can vibrate and, when placed in contact with tissue, can cut and/or coagulate the same, as described here.

[0698] The second electromechanical system is represented by a motor-driven clamping arm 1140 of the end actuator 1122. The motorized movement of a clamping arm of an ultrasonic surgical instrument is described in more detail in relation to Figures 46 to 50. The clamping arm 1140 may be operatively coupled to a motor, which may drive the clamping arm 1140 to transition the end actuator 1122 between an open configuration and a closed configuration to clamp the fabric between the clamping arm 1122 and the 1128 ultrasonic blade.

[0699] Referring to Figure 84, graph 131130 includes three graphs 131132, 131134, 131136 illustrating tissue impedance (Z), power (P), and force (F) plotted on the Y axis as a function of time (t) on the ) is adjusted in the power graph 131134 as the impedance (Z) reaches or exceeds the upper limit defined in the impedance graph 131132. Consequently, the power applied to the transducer 1120 of the first electrosurgical system is governed by the upper limit of the impedance parameter (Z ). At t2 and t3, the tip forces (F) are adjusted in the force chart 131136 as the impedance value reaches or exceeds the lower limit defined in the impedance chart 131132. Consequently, the forces exerted by the clamping member 1122 on the tissue are governed by the lower limit of the impedance parameter (Z).

[0700] In various examples, the current (I) supplied to the motor may be changed as the tissue impedance (Z) reaches or exceeds the lower limit for the purpose of effecting a change in the forces exerted by the clamping member 1122 on the tissue . In at least one example, the motor current (I) can be increased to increase the clamping forces applied to the tissue as the tissue impedance (Z) reaches or exceeds the predetermined lower limit, as illustrated in Figure 84.

[0701] Due to the pivoting movement of the gripping arm of an ultrasonic surgical instrument, more tissue compression is applied to tissue positioned proximally between the claws than to tissue positioned distally between the claws. Less compression of the tissue in a distal portion of the grippers may reduce heat flow to the tissue in the distal portion of the grippers below a threshold level necessary for effective tissue treatment.

[0702] In various aspects, the gripping arm may be equipped with tissue sensing circuitry configured to determine the location of tissue trapped between the jaws of an end actuator. Examples of suitable tissue sensing circuits are described in US Patent No. 8,181,839, filed June 27, 2011, entitled SURGICAL INSTRUMENT EMPLOYINGSENSORS, issued May 5, 2012, the disclosure of which is incorporated herein by reference in its entirety. Various tissue detection techniques are also described in provisional US patent application no. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, and filed on March 30, 2018, which is incorporated herein by reference in its entirety. In at least one example, a tissue detection circuit includes two closely spaced electrodes. When tissue is in contact with the two electrodes, the tissue detection circuit is closed, generating a sensor signal indicative of the presence of tissue, which signal is transmitted to a control circuit (e.g., Figures 13 to 14, 17 to 19).

[0703] A clamping arm load can be adjusted based on the location of the detected tissue. For example, a higher load can be applied in situations where the tissue is concentrated in a distal portion of the claws. The higher load of the clamping arm can be sustained until the tissue trapped in the distal portion of the grippers is almost completely coagulated. The clamping arm load is then reduced to avoid driving the ultrasonic blade into the clamping arm block. In one example, the highest clamping arm load can be sustained up to a predetermined angular distance between the clamping arm and the ultrasonic blade. After the clamping arm reaches or exceeds the predetermined angular distance, the load on the clamping arm is reduced.

[0704] In certain aspects, in connection with a combined device, RF energy may be mixed with load modulation of the gripper arm to provide sufficient heat flow to coagulate tissue concentrated in a distal end portion of the grippers.

Detection of end actuator immersion in liquid

[0705] The frequency response associated with immersing the ultrasonic blade in a liquid is analogous to that associated with a thick tissue trapped between the clamping member and the ultrasonic blade. To avoid accidental triggering of a tissue treatment by the generator that is specific for thick tissue, it is desirable to detect the moment when the ultrasonic blade is immersed in a liquid.

[0706] As described above in relation to Figures 70A to 71, an ultrasonic surgical instrument, or an electrosurgical instrument combination including an ultrasonic component, is configured to detect the immersion of its ultrasonic blade in a liquid (e.g., blood, solution saline, water, etc.) upon detection of an ultrasonic blade temperature significantly below a predetermined limit.

[0707] As previously described, the temperature of the ultrasonic blade can be inferred by detecting the impedance of the ultrasonic transducer given by the following expression: or equivalently, the detection of the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer. The phase angle information Φ can also be used to infer the conditions of the ultrasonic blade. As discussed in particular here, the phase angle Φ changes as a function of the temperature of the ultrasonic blade. Therefore, the phase angle information Φ can be used to control the temperature of the ultrasonic blade.

[0708] Figures 70A and 70B are graphical representations of temperature feedback control to adjust ultrasonic energy applied to an ultrasonic transducer when a sudden drop in temperature of an ultrasonic blade is detected. The temperature of the ultrasonic blade increases with the application of power 133072 as shown in Figure 70A. During use, the temperature of the ultrasonic blade drops suddenly. This can be inferred as the temperature of the ultrasonic blade drops when it is immersed in a surgical field filled with fluid (e.g. blood, saline, water, etc.).

[0709] Immersing the ultrasonic blade in the liquid causes a percentage of the heat produced by the ultrasonic blade to be lost to the liquid. Consequently, immersion increases the heat flow required to deliver an effective treatment, for example tissue coagulation. To modulate the heat flow to a level sufficient to apply effective treatment, the generator modulates the power supplied to the ultrasonic transducer.

[0710] In certain cases, a blend of RF energy and ultrasonic energy can be used to adjust the heat flow to a level sufficient to deliver effective treatment. In certain cases, the compression forces applied to the tissue between the ultrasonic blade and the clamping arm of the surgical instrument can be modulated to adjust the heat flow to a level sufficient to deliver effective treatment.

[0711] In another aspect, as illustrated in Figure 85, detection of an immersion of the ultrasonic blade in a liquid can be inferred from the frequency response of the waveguide/transducer.

[0712] Referring to Figure 85, power (P) is plotted as a function of time in a diagnostic mode, as illustrated in graph 131140, and in a response mode, as illustrated in graph 131142. Power (P) is plotted on the vertical geometric axis, while time (t) is plotted on the horizontal geometric axis. The frequency response of the waveguide/transducer in a liquid is different from an ideal frequency response of the waveguide/transducer in air and is below a predetermined threshold curve 131141. The frequency response curve 131143 of the waveguide /transducer is flattened when the ultrasonic blade is immersed in a liquid rather than having the characteristic rises and flat areas expected in an ideal frequency response curve 131145 that applies effective treatment to the tissue.

[0713] Figure 86 is a logic flow diagram of a process 131150 depicting a control program or logic configuration for detecting and compensating for immersion of an ultrasonic blade in a liquid, in accordance with at least one aspect of the present description. The process 131150 monitors 131152 the power delivered to the tissue over time and compares it to a predetermined threshold. As illustrated in Figure 85, process 131150 can sample the change in power over predetermined periods of time (δP/δt) and compare it to the predetermined limiting slope. If the determined angular coefficient (δp/δt) is below the limiting angular coefficient, it is inferred that the ultrasonic blade is immersed in a liquid that moistens/cools the blade, increasing the heat flow necessary for the blade to apply an effective treatment (turn 131145). To compensate 131156, more power (curve 131147) is supplied to the transducer. The added power is selected to be sufficient to produce the ideal frequency response (curve 131145) when adjusted for the damping effect of the liquid. If, however, the determined slope (δp/δt) is greater than the limiting slope, the application of power to the ultrasonic transducer continues as planned.

[0714] As illustrated in graph 131142 of Figure 85, a modified power curve 131147 is delivered to the tissue in response to sensing that the ultrasonic end actuator is immersed in fluid. Modified power curve 131147 compensates for immersion in liquid. In the example graph 131142, the modified power (P) curve 131147 increases the power supplied to the transducer by a predetermined factor/percentage to achieve the desired power curve 131145.

[0715] In another aspect, detection of an immersion of an end actuator in a liquid may be determined by a liquid detection circuit in the end actuator. The liquid detection circuit may include two electrodes on the end actuator that may be positioned in separate jaws. Alternatively, the electrodes could be positioned in the same clamp. The presence of liquid between the electrodes completes the circuit by transmitting a signal, which can be used to detect the immersion of the end actuator in the liquid. In response to sensing, as described above, the power supplied to the ultrasonic transducer can be modulated to compensate for the damping/cooling effect of immersing the end actuator in the liquid.

[0716] Depending on the degree to which an end actuator is immersed in a liquid and/or the temperature of the liquid, an algorithm can be selected to compensate for heat lost to the liquid in order to perform effective tissue treatment. In at least one example, the power (P) delivered to an ultrasonic transducer can be modulated, as described above, to combat the effects of immersion. Alternatively, compressive forces can be applied to the tissue between the clamping arm and the ultrasonic blade to combat the effects of immersion. In several aspects, both power (P) and tissue compression can be modulated to combat the effects of immersion in the liquid. Merged RF energy and ultrasonic energy modes can also be used to minimize the effects of immersion and could be used in combination with increasing ultrasonic energy, RF power, or clamping arm pressure to achieve effective treatment of the tissue.

[0717] Referring to Figure 87, a graph 131160 represents the power (P) delivered to the tissue by an end actuator 131000 (Figure 73) of an electrosurgical instrument and the temperature (T) of the tissue clamped by the end actuator 131000 as function of the displacement of a closing actuator (e.g., closing member 764 of Figures 18 and 19) that controls the transition of end actuator 131000 to a closed configuration. As described herein, the end actuator 131000 treats tissue by trapping it and applying RF energy and/or ultrasonic energy to the trapped tissue.

[0718] In addition to the foregoing, the closing actuator is operatively coupled to at least one of the grippers 131002, 131004, and is movable to transition the end actuator 131000 between an open configuration and a closed configuration for securing tissue between the grippers 131002, 131004. Consequently, the movement of the closing actuator can represent, or correlate with, the closing movements of the end actuator 131000. Accordingly, there is a correlation between the compression forces applied by the end actuator 131000 to the tissue clamped between the claws 131002, 131004 and the closing actuator displacement.

[0719] Graph 131160 represents a fabric treatment cycle of end actuator 131000. Power (P) is represented on the left vertical axis, temperature (T) is represented on the right vertical axis, and displacement or the translation of the closing actuator (δ) are represented on the horizontal geometric axis. Each δ in the 131160 graph on the horizontal axis represents a distance traveled by the closing actuator from an initial position.

[0720] Stages of the fabric treatment cycle are defined by the positions of the closing trigger. In various aspects, it is desirable to maintain the fabric at a desired temperature, or range of desired temperatures, in one or more of the stages of the fabric treatment cycle. The power (P) delivered to the fabric can be adjusted to maintain tight control of the fabric temperature.

[0721] In the example of Figure 87, an initial stage 131162 represents a gradual increase in power (P) towards the power level (P1) as the closing trigger translates towards δ1. The power (P) is then maintained at a power level (P1) in a first stage 131164 corresponding to a temperature of about 60°C. At this temperature, the tissue undergoes collagen denaturation. Towards the end of the first stage 131164, the power level is raised again to a power level (P2) corresponding to a temperature between 60°C and 100°C at the start of a second stage 131166. Towards the end of the second stage 131166, the power level is raised again toward a power level (P4) configured to cause the tissue to reach and/or exceed a temperature of 100°C.

[0722] On the horizontal geometric axis, the first stage 131164 is defined between a first position in δ1 and a second position in δ2. Power (P) is maintained at power level (P1) as the closing actuator translates toward the second position in δ2. The tissue temperature is maintained at 60°C to facilitate collagen denaturation.

[0723] The second stage 131166 is defined between the second position in δ2 and a third position in δ3. Power (P) is maintained at power level (P2) as the closing actuator translates toward the third position in δ3. During the second stage 131166, it is desirable to maintain the tissue temperature between 60°C and 100°C in an effort to avoid collateral damage to the surrounding tissue, which may be caused by the resulting water vapor at 100°C. In certain cases, however, as illustrated by curve portion 131168 of graph 131160, the tissue temperature may prematurely rise to 100°C before the closing trigger reaches δmax. In several aspects, as illustrated in Figure 87, a predetermined power limit (P3) is set to prevent the tissue from prematurely reaching the boiling temperature of 100°C.

[0724] Figure 88 is a logic flow diagram of a process 131170 depicting a control program or logic configuration for maintaining tissue temperature below 100°C as the clamping arm transitions to a closed configuration at δmax .The process 131170 monitors 131172 the position and/or displacement of the closing trigger. In one example, the position and/or displacement of the closure tube may be monitored via an absolute positioning system 7000, as described in more detail with respect to Figure 80.

[0725] Process 131170 also monitors 131172 the temperature of the tissue, which can be estimated based on the temperature of the ultrasonic blade, for example. If the end actuator 131000 is in the form of an ultrasonic end actuator, or a combined end actuator, the temperature of the ultrasonic blade can be determined by detecting the impedance of the ultrasonic transducer given by the following expression: or equivalently, the detection of the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to the ultrasonic transducer, as described here. Alternatively, the end actuator 131000 may be equipped with one or more temperature sensors to measure tissue temperature.

[0726] Based on the monitored temperature and position information, the process 131170 determines 131174 whether the tissue temperature will prematurely reach or exceed 100°C before the closing trigger reaches or exceeds δmax, as illustrated by the curved portion 131168 of the graph 131160. If this is the case, the process 131170 adjusts 131176 the power (P) to a level that is lower than or equal to the predetermined power limit (P3) to prevent the tissue temperature (T) from reaching 100°C before for the closing trigger to reach or exceed δmax, as illustrated in curve portion 131169.

[0727] In certain aspects, process 131170 may be performed, at least partially, by a control circuit (Figure 13) comprising one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one memory circuit 504 that stores program instructions, which, when executed by processor 502, cause processor 502 to execute process 131170. The control circuit may receive information about the position of the closing trigger from the absolute positioning system 7000, e.g. example. The temperature of the tissue may be determined by the processor 502 from temperature sensor readings or the determined temperature of the ultrasonic blade as described herein.

[0728] In addition to the above, one can determine 131174 whether the tissue temperature will prematurely reach or exceed 100°C before the closing trigger reaches or exceeds δmax, for example, by calculating a temperature trajectory from position, power and/or temperature data at the end of second stage 131166. In one example, a processor 502 may be used to calculate the temperature trajectory from one or more tables and/or equations stored in memory circuit 504, for example.

[0729] In various aspects, process 131170 may be performed by one or more of the control circuits depicted in Figures 14 and 15. In certain aspects, an electrosurgical instrument may include a non-transient storage medium that stores one or more algorithms to run process 131170.

[0730] In at least one example, as illustrated in Figure 87, reaching or exceeding a predetermined limit temperature T1, which is between 60 °C and 100 °C, at a predetermined limit position δ3, which is lower than δmax, may indicate that the tissue temperature will prematurely reach or exceed 100°C before the closing trigger reaches or exceeds δmax. Consequently, if the determined temperature is higher than or equal to the predetermined threshold temperature T1 at the predetermined threshold position δ3, the process 131170 determines 131174 whether the tissue temperature will prematurely reach or exceed 100°C before the closing trigger reaches or exceeds δmax .

[0731] Referring to Figure 89, a graph 131180 comprises four graphs 131182, 131184, 131186, 131188. Graph 131182 represents voltage (V) and current (I) as a function of time (t), graph 131184 represents power (P) as a function of time (t), graph 131186 represents temperature (T) as a function of time (t), and graph 131188 represents tissue impedance (Z) as a function of time (t). In graph 131188, an "impedance bathtub" is illustrated (that is, the tissue impedance as a function of time initially decreases, stabilizes and, finally, increases and the curve becomes similar to the shape of a bathtub).

[0732] Here, time zero represents the first point at which electrosurgical energy is applied to tissue at a surgical site. The Y axis represents the tissue impedance level (Z) present when a substantially constant power level (P) is applied to the tissue, as illustrated in corresponding graph portion 131184. At time zero, the tissue has an initial level of impedance (Zinic). The initial impedance level (Zinic) can be based on native physiological properties around the tissue, such as density, amount of moisture, and tissue type. Over a short period of time, the impedance level actually drops slightly as power is continually applied to the tissue. A minimum impedance level (Zmin) is finally reached. From here the total impedance level increases.

[0733] As the tissue impedance (Z) decreases toward the minimum tissue impedance (Zmin) at time (t1), the current (I) increases and the voltage (V) decreases. The current curve represented in graph 131182 corresponds to the voltage curve L1. The current curves corresponding to the L2 and L3 voltage curves are omitted for clarity. During the initial period (t1), the tissue temperature gradually increases towards 100°C. When the water in the tissue begins to evaporate, the tissue impedance (Z) increases significantly, generating a decline in the current (I) passing through the tissue. As tissue impedance (Z) increases toward 100 Q, tissue temperature also increases toward 110°C, which constitutes a boiling point for certain tissue oils.

[0734] To obtain effective tissue treatment, it is desirable to maintain the tissue below the predetermined maximum temperature. To prevent the tissue temperature from exceeding the predetermined maximum limit temperature, the voltage (V) is increased as indicated in the voltage (V) curves L2 and L3. The increase in voltage (V) prevents the tissue temperature from exceeding the predetermined threshold temperature, as indicated in the temperature curve L3" which corresponds to the voltage curve L3, or at least quickly returns the tissue temperature below the predetermined threshold temperature, as indicated in the temperature curve L2" which corresponds to the voltage curve L2. By comparison, where the voltage (V) is not increased, as indicated in the L1 voltage curve, the tissue temperature of the fabric increases significantly beyond the predetermined threshold temperature, as indicated in the corresponding L1" temperature curve.

[0735] In at least one example, as illustrated in Figure 89, the predetermined maximum temperature is about 130 °C. To keep the tissue below the predetermined maximum temperature, voltage (V) is raised in order to further slow the temperature rise and ultimately reverse the temperature rise.

[0736] In the example of Figure 89, the tissue temperature reaches about 110°C as the tissue impedance (Z) reaches 100 Q, and the tissue temperature (T) reaches about 130°C as the tissue impedance (Z) reaches 450 Q.

[0737] Processes 131190 (Figure 90) and 131200 (Figure 91) represent control programs or logic configurations that employ these tissue impedance (Z) and temperature (T) values as trigger conditions to raise the voltage (V ) toward the end of a fabric treatment cycle applied by an end actuator 131000, as illustrated in Figure 89. Other fabric impedance (Z) and fabric temperature (T) values that can be employed as control conditions trigger to raise the voltage (V) are covered by the present description. In several examples, as illustrated in graph 131188 of Figure 89, the tissue threshold impedance (Z) may be about 100 Q. In other examples, the tissue threshold impedance (Z) may be about 450 Q. In In several examples, as illustrated in graph 131186 of Figure 89, the limiting temperature (T) can be about 110 °C. In other examples, the limiting temperature (T) may be about 130 °C.

[0738] In one example, as illustrated in process 131190 of Figure 90, tissue impedance (Z) can be monitored 131192 and used to determine 131194 when to trigger voltage increase (V) 131196. As described herein in relation to Figure 78A, for example, a detection circuit can be used to determine tissue impedance (Z). Control circuits (e.g., Figures 13 to 15) of an ultrasonic drive circuit and/or an RF drive circuit may be used to perform process 131190 based on input received from the detection circuit.

[0739] In another example, as illustrated in process 131200 of Figure 91, the tissue temperature (T) can be monitored 131202 and used to determine 131204 when to trigger the voltage increase (V) 131206. As described herein in relation to Figures 66A to 68, the generator infers the temperature of the ultrasonic blade based on the phase angle Φ between the voltage signals Vg(t) and current Ig(t) applied to drive the ultrasonic transducer. Alternatively, the tissue temperature may be determined, as described above in relation to Figures 51 to 53, wherein a flexible circuit 8412 may comprise temperature sensors embedded in one or more layers of the flexible circuit 8412. The one or more temperature sensors may be arranged symmetrically or asymmetrically, and provide tissue temperature feedback 8410 to control circuits (e.g., Figures 13 to 15) of an ultrasonic drive circuit and/or an RF drive circuit. Control circuits can be used to execute process 131200 based on temperature feedback.

[0740] In several examples, the voltage (V) is increased gradually, as indicated in voltage curves L2, L3. In other examples, the voltage (V) can be gradually increased.

[0741] In at least one example, two different upper limit temperatures are defined to achieve the power level. The primary and secondary minimum shutdown temperature limits may be employed in addition to the maximum temperature limit.

Combination of ultrasonic and radiofrequency surgical instruments

[0742] As described above, an end actuator 131000 (Figure 73) can be adapted for use with a combined electrosurgical instrument that provides treatment to tissue through the application of radiofrequency (RF) energy alone or in combination with ultrasonic vibrations. Examples of generators configured to drive the ultrasonic transducer and RF electrodes of an end actuator are discussed in more detail in US Patent Publication No. 2017/0202609, titled "Modular Battery Powered Hand-Held Surgical Instrument With Curved End Effectors Asymmetric Engagement Between Jaw and Blade", the entirety of which is incorporated herein by reference.

[0743] In various aspects, an end actuator 131000, including an ultrasonic component and an RF component, is configured to modulate one or more parameters of the RF component based on tissue temperature measurements performed by the ultrasonic component. Consequently, the ultrasonic component can be used in a non-therapeutic diagnostic mode, while the RF component is used in a therapeutic mode to adjust, in real time, one or more parameters of the RF component.

[0744] Figure 92 is a process 131210 depicting a control program or logical configuration for utilizing the ultrasonic component in a non-therapeutic diagnostic mode, while the RF component is being utilized in a therapeutic mode.

[0745] Process 131210 monitors 131212 the temperature of the ultrasonic blade. Process 131210 further determines 131214 whether the temperature of the ultrasonic blade is higher than or equal to a predetermined threshold temperature. If this is the case, process 131210 adjusts the power (P) of the RF component to reduce the energy applied to the tissue.

[0746] As described in relation to Figures 66A to 68, the generator infers the temperature of the ultrasonic blade based on the phase angle Φ between the voltage Vg(t) and current Ig(t) signals applied to drive the ultrasonic transducer . Since the temperature of the ultrasonic blade corresponds to the temperature of the tissue clamped by the end actuator 131000 of the combination device, the ultrasonic component can be used in non-therapeutic diagnostic mode to monitor tissue temperature and provide feedback to adjust the power level of the RF component.

[0747] Figure 93 is a graph 131220 illustrating the execution of process 131210, in accordance with at least one aspect of the present description. Graph 131220 comprises three graphs 131222, 131224, 131226, representing power (P), temperature (T) and phase, respectively, on the vertical geometric axis. The graph 131222 represents the power (P) supplied to the tissue held between the claws 131002, 131004 of an end actuator 131000 of a combined device as a function of time (t). Graph 131224 represents the temperature (T) of the ultrasonic blade of the end actuator 131000 as a function of time (t). Graph 131226 represents the dual non-therapeutic frequencies employed by the ultrasonic component to determine the temperature of the ultrasonic blade and, in turn, the temperature of the tissue, as described in more detail with respect to Figures 66A through 68. The ultrasonic component can be configured to detect a tissue temperature transition to or beyond a predetermined threshold temperature (Tlimit), as illustrated in graph 131224. The power level (P) of the RF component can then be adjusted (P1 to P2) to prevent temperatures excessively high, as illustrated in graph 131222.

[0748] In at least one example, the power level (P) of the RF component is adjusted to maintain tissue temperature below 100°C to prevent water vapor from causing collateral damage to surrounding tissue, while still locally coagulates the collagen in the tissue held by the end actuator 131000 of the combination device. In at least one example, the power level (P) of the RF component is adjusted to maintain the tissue temperature below 130°C to avoid tissue singeing that may occur at that temperature. In at least one example, temperature feedback provided by the ultrasonic component enables the RF component to adjust power rise rates in accordance with tissue phase transitions during a tissue treatment cycle.

[0749] In various aspects, a process comprises a control program or a logical configuration for distinguishing between sections of an ultrasonic blade based on temperature. The process separates small, very hot sections from larger, moderately hot sections of the ultrasonic blade. In at least one aspect, the process includes applying multiple frequencies through 55.5 KHz, which is a standard frequency, and then alternatively using a 3x frequency of 150 KHz, for example, to determine two different resonant frequencies that allow determining a small portion of the ultrasonic blade with a very hot temperature, or a larger portion of the ultrasonic blade with a moderately hot temperature.

[0750] Figure 94 is a logic flow diagram of a process 131230 depicting a control program or logic configuration for adjusting RF waveform frequency of an RF electrosurgical instrument or an RF component of a device combined with based on the measured tissue impedance, in accordance with at least one aspect of the present description. In at least one example, tissue impedance is measured 131232 before or during an early part of a tissue treatment cycle, and the measurement is used to choose 131231 between predetermined high frequency 131234 and low frequency 131236 options in the form of RF wave applied to tissue.

[0751] Process 131230 meets low power transmission conditions. If it is determined that the measured tissue impedance is equal to or lower than a predetermined threshold, the high frequency RF waveform is selected for the treatment cycle. The high-frequency RF waveform is configured to raise tissue impedance to resolve low-power transmission. If, however, it is determined that the measured tissue impedance is higher than or equal to a predetermined threshold, the low-frequency RF waveform is selected for the treatment cycle. In various aspects, tissue impedance can be measured by one or more sensors, as described with respect to Figures 18, 21, 78A.

[0752] In various aspects, one or more of the processes of the present description may be performed by a control circuit of the electrosurgical instrument, such as, for example, the control circuit 710 of the surgical instrument 700, the control circuit 760 of the surgical instrument 750 and/or the control circuit 760 of the surgical instrument 790. In certain aspects, as illustrated in Figure 13, a control circuit for performing one or more of the processes of the present disclosure may comprise one or more processors 502 (e.g., microprocessor, microcontroller) coupled to at least one memory circuit 504 that stores program instructions, which, when executed by processor 502, cause processor 502 to execute the one or more processes. Alternatively, one or more of the processes of the present disclosure may be performed by one or more of the control circuits depicted in Figures 14 and 15. In certain aspects, an electrosurgical instrument may include a non-transient storage media that stores one or more algorithms for executing one or more of the processes of the present description.

[0753] Various aspects of the subject matter described in this document are defined in the following numbered examples:

[0754] Example 1 - A surgical instrument comprising an end actuator comprising an ultrasonic blade and a clamping arm. The clamping arm is movable relative to the ultrasonic blade to transition the end actuator between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further comprises a transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein exceeding a predetermined upper limit of the parameter causes the control circuit to execute a first electromechanical system, and wherein exceeding a predetermined lower limit of the parameter causes the control circuit to execute a second electromechanical system different from the first electromechanical system.

[0755] Example 2 - The surgical instrument of Example 1, where the parameter is tissue impedance.

[0756] Example 3 - The surgical instrument of Example 1, where the parameter is tissue temperature.

[0757] Example 4 - The surgical instrument of any of Examples 1 to 3, where exceeding the predetermined upper limit of the parameter causes the control circuit to make a change in the ultrasonic energy output of the transducer.

[0758] Example 5 - The surgical instrument of any one of Examples 1 to 4, further comprising a motor configured to move the clamping arm toward the closed configuration, and wherein exceeding the predetermined lower limit of the parameter causes the circuit to control system makes a change in the power supplied to the engine.

[0759] Example 6 - The surgical instrument of any one of Examples 1 to 5, wherein the first electromechanical system is configured to seal and cut tissue.

[0760] Example 7 - The surgical instrument of any one of Examples 1 to 6, wherein the second electromechanical system is configured to transition the end actuator between the open configuration and the closed configuration.

[0761] Example 8 - A surgical instrument comprising a first claw, a second claw movable relative to the first claw between an open configuration and a closed configuration for clamping tissue between the first claw and the second claw, a motor configured to move the second claw toward the closed configuration, and a control circuit configured to monitor a parameter of the surgical instrument, wherein reaching a predetermined upper limit of the parameter causes the control circuit to effect a change in the energy applied to the tissue, and wherein reaching a predetermined lower limit of the parameter causes the control circuit to make a change in the energy applied to the motor.

[0762] Example 9 - The surgical instrument of Example 8, where the parameter is tissue impedance.

[0763] Example 10 - The surgical instrument of Example 8, where the parameter is tissue temperature.

[0764] Example 11 - A surgical instrument comprising an end actuator comprising an ultrasonic blade and a clamping arm. The clamping arm is movable relative to the ultrasonic blade to transition the end actuator between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further comprises a transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit configured to monitor a parameter of the surgical instrument, wherein a reading greater than or equal to a predetermined upper limit causes the control circuit to execute a first electromechanical system, and wherein a reading less than or equal to a predetermined lower limit of the parameter causes the control circuit to execute a second electromechanical system different from the first electromechanical system.

[0765] Example 12 - The surgical instrument of Example 11, where the parameter is tissue impedance.

[0766] Example 13 - The surgical instrument of Example 11, where the parameter is tissue temperature.

[0767] Example 14 - The surgical instrument of any of Examples 11 to 13, where exceeding the predetermined upper limit of the parameter causes the control circuit to make a change in the ultrasonic energy output of the transducer.

[0768] Example 15 - The surgical instrument of any one of Examples 11 to 14, further comprising a motor configured to move the clamping arm toward the closed configuration, and wherein falling below the predetermined lower limit of the parameter causes the control circuit makes a change in the power supplied to the engine.

[0769] Example 16 - The surgical instrument of any one of Examples 11 to 15, wherein the first electromechanical system is configured to seal and cut tissue.

[0770] Example 17 - The surgical instrument of any of Examples 11 to 16, wherein the second electromechanical system is configured to transition the end actuator between the open configuration and the closed configuration.

[0771] Although various forms have been illustrated and described, it is not the intention of the applicant to restrict or limit the scope of the claims attached to such detail. Numerous modifications, variations, alterations, substitutions, combinations and equivalents of these forms can be implemented and will occur to those skilled in the art without departing from the scope of the present description. Furthermore, the structure of each element associated with the form can alternatively be described as a means to provide the function performed by the element. Furthermore, where materials for certain components are described, other materials may be used. It should be understood, therefore, that the foregoing description and the appended claims are intended to cover all such modifications, combinations and variations falling within the scope of the presented embodiments. The attached claims are intended to cover all such modifications, variations, alterations, substitutions, modifications and equivalents.

[0772] The preceding detailed description has presented various forms of the devices and/or processes through the use of block diagrams, flowcharts and/or examples. Although these block diagrams, flowcharts and/or examples contain one or more functions and/or operations, it will be understood by those skilled in the art that each function and/or operation within these block diagrams, flowcharts and/or examples can be implemented, individually. and/or collectively, across a wide range of hardware, software, firmware or virtually any combination thereof. Those skilled in the art will recognize, however, that some aspects of the aspects described herein, in whole or in part, may be equivalently implemented on integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or virtually any combination thereof, and that designing the circuitry and/or writing the code for the software and firmware would be within the scope of practice of one skilled in the art, in light of this description. Furthermore, those skilled in the art will understand that the mechanisms of the subject matter described herein may be distributed as one or more program products in a variety of forms and that an illustrative form of the subject matter described herein is applicable regardless of the specific type of data transmission medium. signals used to effectively carry out distribution.

[0773] Instructions used to program logic to perform various aspects described may be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Additionally, instructions may be distributed over a network or through other computer-readable media. Thus a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, floppy disks, optical discs, read-only memory compact disk ( CD-ROMs), and optical disks - dynamo disks, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), cards magnetic or optical devices, flash memory, or a tangible machine-readable storage medium used in the transmission of information over the Internet via an electrical, optical, acoustic cable, or other forms of propagated signals (e.g., carrier waves, infrared signal, digital signals, etc.). Accordingly, non-transitory computer-readable media includes any type of machine-readable media suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

[0774] As used in any aspect of the present invention, the term "control circuit" may refer to, for example, a set of wired circuits, programmable circuits (e.g., a computer processor comprising one or more cores individual instruction processing unit, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array ( FPGA)), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination thereof. The control circuit may, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, e.g., an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system embedded on board (SoC) ), desktop-type computers, laptop-type computers, tablet-type computers, servers, smartphones, etc. Accordingly, as used herein, "control circuit" includes, but is not limited to, electrical circuits that have at least one isolated electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit for specific application, electrical circuits that form a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that, at least partially, executes processes and/or devices described herein, or a microprocessor configured by a computer program that, at least partially, executes the processes and/or devices described herein), electrical circuits that form a memory device (e.g., forms of random access memory), and/or circuits electrical devices that form a communications device (for example, a modem, communication switch, or optical-electrical equipment). Those skilled in the art will recognize that the subject matter described herein can be implemented in analog or digital mode, or in some combination thereof.

[0775] As used in any aspect of the present invention, the term "logic" may refer to an application, software, firmware and/or circuit configured to perform any of the aforementioned operations. The software may be embodied as a software package, code, instructions, instruction sets and/or data recorded on non-transitory computer-readable storage media. Firmware may be embodied as code, instructions or sets of instructions, and/or data that are hard-coded (e.g., non-volatile) in memory devices.

[0776] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, whether hardware, a combination of hardware and software, software or running.

[0777] As used herein in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and/or logical states that can, although they need not necessarily, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common usage to call these signals bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms may be associated with appropriate physical quantities and are merely convenient identifications applied to such quantities and/or states.

[0778] A network may include a packet switched network. Communication devices may be capable of communicating with each other using a selected packet switched network communications protocol. An exemplary communications protocol may include an Ethernet communications protocol that may be capable of enabling communication using a transmission control protocol/Internet protocol (TCP/IP). The Ethernet protocol may conform to or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) entitled "IEEE 802.3 Standard" published in December 2008 and/or later versions of this standard. Alternatively or additionally, the communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol may conform to or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may be able to communicate with each other using a frame-relay communications protocol. The frame-relay communications protocol may conform to or be compatible with a standard promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be able to communicate with each other using an ATM ("asynchronous transfer mode" communication protocol). The ATM communication protocol may conform to or be compatible with an ATM standard published by the ATM forum entitled "ATM-MPLS Network Interworking 2.0" published in August 2001, and/or later versions of that standard. Obviously, different and/or post-developed connection-oriented network communication protocols are also contemplated in the present invention.

[0779] Unless expressly stated otherwise, as is evident from the foregoing description, it is understood that throughout the foregoing description, discussions using terms such as "processing", or "computation", or "calculation", or " determination", or "display", or similar, refer to the action and processes of a computer, or similar electronic computing device, that manipulates and transforms data represented in the form of physical (electronic) quantities in records and memories computer in other data similarly represented in the form of physical quantities in computer memories or records, or in other similar information storage, transmission or display devices.

[0780] One or more components may be referred to in the present invention as "configured for", "configurable for", "operable for", "adapted for", "capable of", "conformable for", etc. Those skilled in the art will recognize that "configured for" may generally encompass components in an active state and/or components in an inactive state and/or components in a standby state, except where the context dictates otherwise.

[0781] The terms "proximal" and "distal" are used herein with reference to a physician who manipulates the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located in the direction away from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" may be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

[0782] Persons skilled in the art will recognize that, in general, terms used herein, and particularly in the appended claims (e.g., bodies of appended claims) are generally intended as "open" terms (e.g., the term "including" shall be construed as "including, but not limited to", the term "having" shall be construed as "having, at least", the term "includes" shall be construed as "includes, but is not limited to ", etc.). It will further be understood by those skilled in the art that, when a specific number of an introduced claim statement is intended, such intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following attached claims may contain use of the introductory phrases "at least one" and "one or more" to introduce claim mentions. However, the use of such phrases should not be interpreted as implying that the introduction of a mention of the claim by the indefinite articles "a, ones" or "a, ones" limits any specific claim containing the introduced claim mention to claims containing only such mention, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles such as "one, ones" or "a, ones" (e.g., "one, ones" and /or "one" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of definite articles used to introduce claims.

[0783] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that such mention needs to typically be interpreted as meaning at least the mentioned number (e.g., the mere mention of "two mentions", without other modifiers, typically means at least two mentions, or two or more mentions). Furthermore, in cases where a convention analogous to "at least one of A, B, and C, etc." is used, this construction is generally intended to have the sense in which the convention would be understood by (e.g., "a system that has at least one of A, B, and C" would include, but is not limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/ or A, B and C together, etc.). In cases in which a convention analogous to "at least one of A, B, or C, etc." is used, this construction is generally intended to have the sense in which the convention would be understood by (e.g., "a system that has at least one of A, B, and C" would include, but is not limited to, systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A , B and C together, etc.). It will further be understood by those skilled in the art that typically a word and/or a disjunctive phrase presenting two or more alternative terms, whether in the description, the claims or the drawings, should be understood as contemplating the possibility of including one of the terms, any of the terms or both terms, except when the context determines to indicate otherwise. For example, the phrase "A or B" will typically be understood as including the possibilities of "A" or "B" or "A and B".

[0784] With respect to the attached claims, those skilled in the art will understand that the operations mentioned therein can generally be performed in any order. Furthermore, although various operational flow diagrams are presented in one or more sequences, it should be understood that the various operations may be performed in orders other than those illustrated, or may be performed simultaneously. Examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse, or other variant orderings, except where the context dictates otherwise. Furthermore, terms such as "responsive to", "related to" or other adjective participles are not generally intended to exclude these variants, except when the context dictates otherwise.

[0785] It is worth noting that any reference to "one (1) aspect", "an aspect", "an exemplification" or "one (1) exemplification", and the like means that a particular feature, structure or characteristic described in connection with the aspect is included in at least one aspect. Accordingly, the use of expressions such as "in one (1) aspect", "in one aspect", "in an exemplification", "in one (1) exemplification", in various places throughout this specification does not necessarily refer to the same aspect. Furthermore, specific features, structures or characteristics may be combined in any suitable manner in one or more aspects.

[0786] Any patent application, patent, non-patent publication or other disclosure material mentioned in this specification and/or mentioned in any application data sheet is incorporated herein by reference, to the extent that the incorporated materials are not inconsistent with it. Accordingly, and to the extent necessary, the description as explicitly set forth herein supersedes any conflicting material incorporated into the present invention by reference. Any material, or portion thereof, which is incorporated herein by reference but which conflicts with the existing definitions, statements, or other descriptive materials set forth herein is incorporated herein only to the extent that there is no conflict between the incorporated material and the existing description material.

[0787] In summary, numerous benefits have been described that result from the use of the concepts described in this document. The aforementioned description of one or more embodiments has been presented for purposes of illustration and description. This description is not intended to be exhaustive nor to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. One or more embodiments have been chosen and described for the purpose of illustrating the principles and practical application and thereby enabling one skilled in the art to use the various modalities and with various modifications as may be convenient for the specific use contemplated. The attached claims are intended to define the overall scope.

Claims (6)

1. Surgical instrument (1104), comprising: an end actuator (1122), comprising: an ultrasonic blade (1128); and a gripping arm (1140) comprising tissue sensing circuitry (3314) and movable relative to the ultrasonic blade (1128) to transition the end actuator (1122) between an open configuration and a closed configuration for gripping tissue. between the ultrasonic blade (1128) and the clamping arm (1140); a transducer (1120) configured to generate an ultrasonic energy output; a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade (1128); and a control circuit (760) configured to: determine a position of the fabric based on data received from the fabric detection circuit (3314), and adjust a clamping arm load (1140) based thereon; monitor a parameter of the surgical instrument (1104), wherein the parameter causes the control circuit (760) to effect a first electromechanical system (132002) and a second electromechanical system (132002), the first electromechanical system (132002) is configured to seal and cut the tissue and the second electromechanical system (132002) is configured to apply a force by the end actuator (1122) to the tissue located between the clamping arm (1140) and the ultrasonic blade (1128), and in that the first and second electromechanical systems (132002) are coordinated in operation to produce a correlated effect on the tissue; determining that the parameter exceeds a predetermined upper limit of the parameter that causes the control circuit (760) to reduce a power delivered to the tissue and maintain the force applied by the end actuator (1122) to the tissue located between the clamping arm (1140 ) and the ultrasonic blade (1128), with the correlated effect on the tissue reducing the parameter below the predetermined upper limit; determining that the parameter exceeds a predetermined lower limit of the parameter that causes the control circuit (760) to maintain power delivered to the tissue and increase the force applied by the end actuator (1122) to the tissue located between the clamping arm (1140 ) and the ultrasonic blade (1128), in which the correlated effect on the tissue increases the parameter above the predetermined lower limit; characterized by the fact that it further comprises: determining that the parameter increases above the predetermined lower limit of the parameter that causes the control circuit (760) to maintain the power delivered to the tissue and decrease the force applied by the end actuator (1122) to the tissue located between the clamping arm (1140) and the ultrasonic blade (1128), wherein the correlated effect on the tissue increases the parameter above the predetermined upper limit; and determining that the parameter increases above the predetermined upper limit of the parameter that causes the control circuit (760) to increase the power delivered to the tissue and maintain the force applied by the end actuator (1122) to the tissue located between the clamping arm (1140) and the ultrasonic blade (1128), in which the correlated effect on the tissue increases the parameter until reaching a final limit. 2. Surgical instrument (1104), according to claim 1, characterized by the fact that the parameter is tissue impedance. 3. Surgical instrument (1104), according to claim 1, characterized by the fact that the parameter is tissue temperature. 4. Surgical instrument (1104), according to claim 1, characterized by the fact that exceeding the predetermined upper limit of the parameter causes the control circuit (760) to make a change in the ultrasonic energy output of the transducer (1120 ). 5. Surgical instrument (1104), according to claim 1, characterized by the fact that it further comprises a motor configured to move the clamping arm (1140) towards the closed configuration, and which exceeds the predetermined lower limit of the parameter causes the control circuit (760) to make a change in the power supplied to the engine. 6. Surgical instrument (1104), according to claim 1, characterized by the fact that exceeding the predetermined lower limit of the parameter inhibits the first electromechanical system (132002) from cutting and sealing the tissue.